An effect of this magnitude is not generally expected to be clinically relevant. In patients receiving concomitant therapy with rifampicin, the appropriate treatment regimen should be used (see section 4.2).In a study in healthy volunteers, lopinavir/ritonavir approximately halved the plasma concentrations of lamotrigine, probably by induction of glucuronidation. B), when halving since this may cause the tablet to crumble.If the calculated dose of lamotrigine (for example for treatment of children with epilepsy or patients with hepatic impairment) does not equate to whole tablets, the dose to be administered is that equal to the lower number of whole tablets.For doses not realisable/practicable with this medicinal product, other strengths of this medicinal product or other pharmaceutical forms and products are available.Prescribers should assess the need for escalation to maintenance dose when restarting Lamotrigine in patients who have discontinued Lamotrigine for any reason, since the risk of serious rash is associated with high initial doses and exceeding the recommended dose escalation for lamotrigine (see section 4.4). • Seizures associated with Lennox-Gastaut syndrome. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. on days 15 to 21 of the pill cycle. Because of a risk of rash the initial dose and subsequent dose escalation should not be exceeded (see section 4.4).When concomitant AEDs are withdrawn or other AEDs/medicinal products are added on to treatment regimes containing lamotrigine, consideration should be given to the effect this may have on lamotrigine pharmacokinetics (see section 4.5).To achieve maintenance, doses may increased by maximum of 50-100 mg every one to two weeks until optimal response is achieved.500 mg/day has been required by some patients to achieve desired response.This dosage regimen should be used with valproate regardless of any concomitant medicinal productsTo achieve maintenance, doses may be increased by maximum of 25-50 mg every one to two weeks until optimal response is achievedThis dosage regimen should be used without valproate but with:To achieve maintenance, doses may be increased by maximum of 100 mg every one to two weeks until optimal response is achieved700mg/day has been required by some patients to achieve desired responseThis dosage regimen should be used with other medicinal products that do not significantly inhibit or induce lamotrigine glucuronidationTo achieve maintenance, doses may be increased by maximum of 50-100 mg every one to two weeks until optimal response is achievedIn patients taking medicinal products where the pharmacokinetic interaction with lamotrigine is currently not known (see section 4.5), the treatment regimen as recommended for lamotrigine with concurrent valproate should be used.1-15 mg/kg/day, although some patients have required higher doses (up to 15 mg/kg/day) to achieve desired response (once a day or two divided doses)To achieve maintenance, doses may be increased by maximum of 0.6 mg/kg/day every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 200 mg/dayThis dosage regimen should be used with valproate regardless of any other concomitant medicinal productsTo achieve maintenance, doses may be increased by maximum of 0.3 mg/kg/day every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 200mg/dayThis dosage regimen should be used without valproate but with:To achieve maintenance, doses may be increased by maximum of 1.2mg/kg/day every one to two weeks until optimal response is achieved, with a maximum maintenance dose of 400 mg/day.This dosage regimen should be used with other medicinal products that do not significantly inhibit or induce lamotrigine glucuronidationTo achieve maintenance, doses may be increased by maximum of 0.6mg/kg/day every one to two weeks until optimal response is achieved, with a maximum of maintenance dose of 200 mg/dayIn patients taking medicinal products where the pharmacokinetic interaction with lamotrigine is currently not known (see section 4.5), the treatment regimen as recommended for lamotrigine with concurrent valproate should be used. Therefore, consideration should be given to using contraception without a pill-free week, as first-line therapy (for example, continuous hormonal contraceptives or non-hormonal methods; see sections 4.4 and 4.5).The maintenance dose of lamotrigine will in most cases need to be increased by as much as two-fold (see sections 4.4 and 4.5).

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