Lamictal XR Dosage

Dosage forms:  ER TAB: 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg; blue convenience pack; green convenience pack; orange convenience pack

Partial seizures

[conversion to monotherapy]

Dose: 250-300 mg PO qd; Start: see pkg insert for titration schedule; Info: for conversion to lamotrigine monotherapy from AED monotherapy; not for initial monotherapy or conversion from AED combo tx; dose adjustment may be needed during pregnancy and/or postpartum; do not cut/crush/chew tab; taper dose over 2wk to D/C

[valproate adjunct]

Dose: 200-250 mg PO qd; Start: blue starter pack (25 mg PO qod x2wk, then 25 mg PO qd x2wk, then 50 mg PO qd x1wk), then incr. by 50 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: applies to any regimen containing a valproic acid derivative; dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

[enzyme-inducing AED adjunct]

Dose: 400-600 mg PO qd; Start: green starter pack (50 mg PO qd x2wk, then 100 mg PO qd x2wk, then 200 mg PO qd x1wk), then incr. by 100 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

[non-valproate, non-inducing AED adjunct]

Dose: 300-400 mg PO qd; Start: orange starter pack (25 mg PO qd x2wk, then 50 mg PO qd x2wk, then 100 mg PO qd x1wk), then incr. by 50 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

Seizures, primary generalized tonic clonic

[valproate adjunct]

Dose: 200-250 mg PO qd; Start: blue starter pack (25 mg PO qod x2wk, then 25 mg PO qd x2wk, then 50 mg PO qd x1wk), then incr. by 50 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: applies to any regimen containing a valproic acid derivative; dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

[enzyme-inducing AED adjunct]

Dose: 400-600 mg PO qd; Start: green starter pack (50 mg PO qd x2wk, then 100 mg PO qd x2wk, then 200 mg PO qd x1wk), then incr. by 100 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: enzyme-inducing AEDs incl. carbamazepine, phenytoin, phenobarbital, primidone; dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

[non-valproate, non-inducing AED adjunct]

Dose: 300-400 mg PO qd; Start: orange starter pack (25 mg PO qd x2wk, then 50 mg PO qd x2wk, then 100 mg PO qd x1wk), then incr. by 50 mg/day qwk x2wk, then incr. by up to 100 mg/day qwk; Info: dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

Migraine headache w/ aura prophylaxis

[100 mg PO qd]

Start: 25 mg PO qd x2wk, may incr. by 25 mg/day qwk; Info: dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C; not 1st-line tx

Neuropathic pain, diabetic

[200-400 mg PO qd]

Start: 25 mg PO qd x2wk, then 50 mg PO qd x2wk, then may incr. dose qwk; Max: 400 mg/day; Info: dose adjustment may be needed during pregnancy and/or postpartum; may convert from IR to ER at same total daily dose; do not cut/crush/chew tab; taper dose over 2wk to D/C

Renal dosing

significant impairment: consider decr. usual dose

HD/PD: not defined

Hepatic dosing

[adjust dose amount]

mod-severe impairment: decr. dose 25%; severe impairment w/ ascites: decr. dose 50%