Lamictal Xr

Swallow whole. Take once daily. Adjunctive therapy for primary generalized tonic-clonic and partial onset seizures: ≥13yrs: adding to antiepileptic drug (AED) regimens that include valproate: initially 25mg every other day for 2 weeks, then 25mg once daily for 2 weeks, then 50mg once daily for 1 week, then 100mg once daily for 1 week, then 150mg once daily for 1 week; followed by maintenance range 200–250mg/day. For patients not taking carbamazepine, phenytoin, phenobarbital, primidone, or valproate: initially 25mg once daily for 2 weeks, then 50mg once daily for 2 weeks, then 100mg once daily for 1 week, then 150mg once daily for 1 week, then 200mg once daily for 1 week; followed by maintenance range 300–400mg/day. Adding to AED regimens without valproate: initially 50mg once daily for 2 weeks, then 100mg once daily for 2 weeks, then 200mg once daily for 1 week, then 300mg once daily for 1 week, then 400mg once daily for 1 week; followed by maintenance range 400–600mg/day. Conversion from adjunctive therapy with carbamazepine, phenytoin, phenobarbital, or primidone to monotherapy: after achieving a dosage of 500mg/day of Lamictal XR using guidelines above, withdraw concomitant AED by 20% decrements each week over a 4-week period, then 2 weeks after completion of withdrawal of AED, decrease Lamictal XR dose no faster than 100mg/day each week to acheive monotherapy maintenance dosage range of 250–300mg/day. Conversion from adjunctive therapy with valproate to monotherapy: Step 1: achieve dosage of Lamictal XR 150mg/day using guidelines above while maintaining stable dose of valproate; Step 2: maintain Lamictal XR 150mg/day while decreasing valproate dose by decrements no greater than 500mg/day each week to 500mg/day and then maintain for 1 week; Step 3: increase Lamictal XR to 200mg/day while simultaneously decreasing valproate to 250mg/day and maintain for 1 week; Step 4: increase Lamictal XR dose to 250 or 300mg/day and discontinue valproate. Conversion from adjunctive therapy with AED other than the above mentioned: after achieving a dosage of Lamictal XR 250–300mg/day using above guidelines, withdraw concomitant AED by 20% decrements each week for 4-week period; no adjustment to Lamictal XR monotherapy dose is needed. Converting from lamotrigine immediate-release tabs: give initial dose to equal total daily dose of immediate-release; monitor and adjust as needed. Concomitant estrogen-containing oral contraceptives, hormone replacement therapy, lopinavir/ritonavir, or atazanavir/ritonavir: see full labeling. Hepatic impairment: if moderate or severe (w/o ascites) reduce dose by 25%; if severe (w. ascites) reduce dose by 50%.