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Lamotrigine Interactions with Drugs, Food & Conditions

Interactions may occur when taking tramadol with lamotrigine. These interactions may include an increase in side effects such as dizziness, drowsiness, difficulty concentrating and confusion. There may also be a motor concentration, judgment or thinking impairment in the elderly.

Lamotrigine

Generic name: lamotrigine [ la-MOE-tri-jeen ]
Brand names: LaMICtal, LaMICtal ODT, LaMICtal XR, Subvenite, LaMICtal CD, . show all 20 brands LaMICtal Starter Kit (Blue), LaMICtal Starter Kit (Green), LaMICtal Starter Kit (Orange), LaMICtal ODT Patient Titration Kit (Blue), LaMICtal ODT Patient Titration Kit (Orange), LaMICtal ODT Patient Titration Kit (Green), LaMICtal XR Patient Titration Kit (Blue), LaMICtal XR Patient Titration Kit (Orange), LaMICtal XR Patient Titration Kit (Green), LamoTRIgine Starter Kit (Blue), LamoTRIgine Starter Kit (Green), LamoTRIgine Starter Kit (Orange), Subvenite Starter Kit (Blue), Subvenite Starter Kit (Green), Subvenite Starter Kit (Orange)
Dosage forms: oral tablet (100 mg; 150 mg; 200 mg; 25 mg; blue; green; orange); oral tablet, disintegrating (100 mg; 200 mg; 25 mg; 50 mg; blue; green; orange); oral tablet, dispersible (2 mg; 25 mg; 5 mg); oral tablet, extended release (100 mg; 200 mg; 25 mg; 250 mg; 300 mg; 50 mg; blue; green; orange)
Drug class: Triazine anticonvulsants

Medically reviewed by Drugs.com on Oct 10, 2022. Written by Cerner Multum.

What is lamotrigine?

Lamotrigine is an anti-epileptic medication, also called an anticonvulsant.

Lamotrigine is used alone or with other medications to treat epileptic seizures in adults and children. Lamotrigine is also used to delay mood episodes in adults with bipolar disorder (manic depression).

Immediate-release lamotrigine can be used in children as young as 2 years old when it is given as part of a combination of seizure medications. However, this form should not be used as a single medication in a child or teenager who is younger than 16 years old.

The average length of the portion of a doctor appointment in which the patient actually sees the doctor is up from previous years, rising by about 12 seconds per year, according to Reuters. However, 60% of physicians report dissatisfaction with the amount of time they spend with their patients, athenaInsight Many doctors now spend more time on paperwork than seeing patients, and a primary care physician who spends 5 minutes of face-to-face time with a patient will spend another 19.3 minutes, on average, working on that patient’s electronic health records (EHRs).

Extended-release lamotrigine is for use only in adults and children who are at least 13 years old.

Lamotrigine may also be used for purposes not listed in this medication guide.

Warnings

Lamotrigine may cause a severe or life-threatening skin rash, especially in children and in people who take a very high starting dose, or those who also take valproic acid (Depakene) or divalproex (Depakote). Seek emergency medical attention if you have a skin rash, hives, blistering, peeling, or sores in your mouth or around your eyes.

Call your doctor at once if you have signs of other serious side effects, including: fever, swollen glands, severe muscle pain, bruising or unusual bleeding, yellowing of your skin or eyes, headache, neck stiffness, vomiting, confusion, or increased sensitivity to light.

Some people have thoughts about suicide while taking lamotrigine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

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Before taking this medicine

You should not take lamotrigine if you are allergic to it.

Lamotrigine may cause a severe or life-threatening skin rash, especially in children and in people who take a very high starting dose, or those who also take valproic acid (Depakene) or divalproex (Depakote).

Tell your doctor if you have ever had:

  • a rash or allergic reaction after taking another seizure medication;
  • kidney or liver disease;
  • heart problems such as heart block or irregular heartbeats;
  • depression, suicidal thoughts or actions; or
  • meningitis (inflammation of the tissue that covers the brain and spinal cord) after taking lamotrigine.

Some people have thoughts about suicide while taking lamotrigine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of lamotrigine on the baby.

Birth control pills can make lamotrigine less effective, resulting in increased seizures. Tell your doctor if you start or stop using birth control pills. Your lamotrigine dose may need to be changed.

It may not be safe to breastfeed while using lamotrigine. Ask your doctor about any risk.

How should I take lamotrigine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Taking too much lamotrigine at the start of treatment may increase your risk of a severe life-threatening skin rash.

You may need frequent blood tests to help your doctor make sure you are taking the right dose.

Extended-release and immediate-release lamotrigine may be used for different conditions. Always check your refills to make sure you have received the correct size, color, and shape of tablet. Avoid medication errors by using only the form and strength your doctor prescribes.

If you switch to lamotrigine from another seizure medicine, carefully follow your doctor’s instructions about the timing and dosage of your medicine.

Swallow the tablet whole and do not crush, chew, or break it.

Read and carefully follow any Instructions for Use provided with the orally disintegrating or dispersible tablets. Ask your doctor or pharmacist if you do not understand these instructions.

Do not stop using lamotrigine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

In case of emergency, wear or carry medical identification to let others know you use seizure medication.

Lamotrigine may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you use lamotrigine.

Store at room temperature away from light and moisture.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include blurred vision, problems with coordination, increased seizures, feeling light-headed, or fainting.

What should I avoid while taking lamotrigine?

Avoid driving or hazardous activity until you know how lamotrigine will affect you. Your reactions could be impaired.

Lamotrigine side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

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If you have to stop taking lamotrigine because of a serious skin rash, you may not be able to take it again in the future.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Lamotrigine may cause serious side effects. Call your doctor at once if you have:

  • fast, slow, or pounding heartbeats or fluttering in your chest;
  • chest pain, shortness of breath;
  • fever, swollen glands, weakness, severe muscle pain;
  • any skin rash, especially with blistering or peeling;
  • painful sores in your mouth or around your eyes;
  • headache, neck stiffness, increased sensitivity to light, nausea, vomiting, confusion, drowsiness;
  • jaundice (yellowing of the skin or eyes); or
  • pale skin, cold hands and feet, easy bruising, unusual bleeding.

Common side effects of lamotrigine may include:

  • headache, dizziness;
  • blurred vision, double vision;
  • tremor, loss of coordination;
  • dry mouth, nausea, vomiting, stomach pain, diarrhea;
  • fever, sore throat, runny nose;
  • drowsiness, tired feeling;
  • back pain; or
  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lamotrigine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Other drugs may affect lamotrigine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

You should take lamotrigine at night if it makes you sleepy and if you are prescribed it once a day. But if it doesn’t make you sleepy or if it tends to keep you awake, then take it first thing in the morning. If you are prescribed lamotrigine twice a day, then space out the dosages as much as you can, which means taking one dose first thing in the morning and one dose at night. Continue reading

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Further information

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Copyright 1996-2023 Cerner Multum, Inc. Version: 20.01.

Lamotrigine Interactions with Drugs, Food & Conditions

There may be some instances where lamotrigine (Lamictal) interactions can occur, as is the case with any other medication. If there are interactions, use is not recommended or the usage amount and timeframe will have to be adjusted in order to prevent or reduce the risk of negative interactions occurring from other drugs, medical conditions, or even food and drink.

Drug Interactions

According to the FDA, these drugs may interact with this medication.

  • Estrogen-containing oral contraceptive preparations that have levonorgestrel and ethinyl estradiol
  • Rifampin
  • Carbamazepine/Carbamazepine epoxide
  • Valproate
  • Lopinavir/Ritonavir
  • Phenytoin
  • Phenobarbital/Primidone
  • Atazanavir/Ritonavir

Please understand that this list may not be complete. There may be other interactions with drugs that are not listed here.

Antibiotics

There are currently no potential interactions between lamotrigine and antibiotics. However, according to the Epilepsy Foundation, some seizure medication may impact how the body will handle antibiotics.

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Acetaminophen (Tylenol)

There have been no reported interactions between acetaminophen (Tylenol) and lamotrigine.

Depakote (Divalproex sodium)

Using lamotrigine while taking Depakote may cause serious skin rashes, tremors, restlessness, seizures, muscle weakness and a staggered walk. Always tell your doctor if you are taking Depakote when prescribed lamotrigine. Your doctor may adjust the dosage amount or seek an alternative medication.

Antihistamines

Taking antihistamines such as Benadryl along with lamotrigine may cause a person to experience an increase in side effects such as drowsiness, confusion, dizziness, and difficulty concentrating. The elderly may also experience an impairment in motor concentration, thinking or judgment.

Tramadol (ConZip, Ultram)

Interactions may occur when taking tramadol with lamotrigine. These interactions may include an increase in side effects such as dizziness, drowsiness, difficulty concentrating and confusion. There may also be a motor concentration, judgment or thinking impairment in the elderly.

Gabapentin (Gralise)

There are no reported drug interactions when taking gabapentin and lamotrigine, although side effects may be increased.

Wellbutrin (Bupropion)

There are no reported drug interactions when taking Wellbutrin with lamotrigine.

Sertraline (Zoloft)

Sertraline may cause blood sodium level to get too low (hyponatremia) as lamotrigine can cause an increase to this risk. The drug sertraline may also cause a person to experience seizures, which will reduce the effectiveness of lamotrigine.

Prozac (Fluoxetine)

Hyponatremia, a condition where the blood sodium levels reach very low levels, may occur when taking Prozac as the drug lamotrigine can make this side effect worse. The effects of lamotrigine may be reduced due to Prozac and occasionally cause seizures in patients.

Food Interactions

The foods and the beverages we consume can also sometimes interact with our medications. Food and drink that may interact with this drug may include:

Always be advised that this list may not be complete. Other foods and beverages may interact with this drug.

Lamotrigine and Alcohol

For more information, please visit our page on lamotrigine and alcohol interactions.

Supplements

Lamotrigine is not known to negatively interact with supplements.

Grapefruit and Grapefruit Juice

There is no known interaction between grapefruit juice or grapefruit with Lamotrigine. However, grapefruit and grapefruit juice may negatively interact with some bipolar medications.

Herbs and Herbal Supplements

Some herbs and herbal supplements may cause mania symptoms in people who have bipolar or worsen seizures, which can impact the effectiveness of lamotrigine.

Disease & Conditions Interactions

Sometimes certain medications can increase the risk of negative side effects for patients with certain diseases or other medical conditions. According to the FDA, diseases and medical conditions that are known to negatively interact with lamotrigine include:

  • Skin rashes
  • Blood Dyscrasias
  • Aseptic Meningitis
  • Heart Disease
  • Renal/Liver Disease
  • Phenylketonuria (PKU)
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  • Depression/suicidal tendencies
  • Hemophagocytic lymphohistiocytosis (HLH)
  • Withdrawal seizures

Please understand that this list may not be complete. Other diseases and medical conditions may interact with this drug as patients should not take this medication.

Lamotrigine and Pregnancy

For more information, please visit our page on lamotrigine and pregnancy risks.

Breastfeeding

For more information, please visit our page on lamotrigine and pregnancy risks.

Weight Gain

There is no known correlation to taking lamotrigine and gaining weight. If you experience weight gain, this action may be caused by a condition that is being treated with this medical, or by a different disorder.

Hair Loss

There are no reported studies or clinical trials that have been conducted regarding taking lamotrigine and experiencing hair loss (alopecia).

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

More about Lamotrigine

  • Pregnancy Risks
  • Withdrawal
  • Lamotrigine and Alcohol Interactions
  • Lamotrigine Alternatives
  • Lamotrigine for Depression
  • Lamotrigine for Bipolar
  • Lamotrigine for Anxiety

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