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Precautions and Warnings With Extended-Release Lamotrigine

People who are allergic to any of the ingredients in extended-release lamotrigine should not take it. Other important warnings and precautions with extended-release lamotrigine include being aware that this medicine can cause liver failure, blood disorders, and serious skin rashes. You can help ensure a safe treatment by telling your healthcare provider about your medical history and current medications.

What Should I Tell My Healthcare Provider?

Prior to taking extended-release lamotrigine (Lamictal® XR™), talk to your healthcare provider if you have:
  • Depression or a history of suicidal thoughts or behavior
  • Liver disease, such as liver failure or cirrhosis
  • Kidney disease, including kidney failure (renal failure)
  • A blood disorder
  • Any allergies, including to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all medicines you take, including prescription and nonprescription drugs, vitamins, and herbal supplements.

Specific Extended-Release Lamotrigine Warnings and Precautions

Precautions and warnings to be aware of prior to taking extended-release lamotrigine include the following:
  • Extended-release lamotrigine can cause life-threatening skin rashes (see Lamictal Rash). Tell your healthcare provider right away if you develop any rash while taking this medicine.
  • Extended-release lamotrigine can cause life-threatening allergic reactions -- sometimes even without the typical serious skin rash. These reactions can cause organ failure and even death. Let your healthcare provider know immediately if you have any early signs of such an allergic reaction, including:
    • Fever
    • Swollen lymph nodes (swollen "glands")
    • Swelling of the mouth or lips
    • Difficulty breathing.
  • There have been cases of liver failure caused by extended-release lamotrigine. Children under two years old are at especially high risk for this, especially children with mental retardation, brain damage or disease, or certain other health problems. This drug is not approved for children under 13 years old and should rarely be used in young children, due to the risk of liver damage.
  • Extended-release lamotrigine can cause anemia or other blood disorders that might increase your risk of bleeding or infections. Tell your healthcare provider if you have any unusual bruising or bleeding, as well as any frequent infections, during treatment.
  • Studies suggest that seizure medications may increase the risk of suicidal thoughts or behaviors. Along with their friends and family, people taking extended-release lamotrigine should be aware of this risk and should be watchful for any changes in mood or behavior.
  • As with all seizure medications, extended-release lamotrigine should not be stopped suddenly, as this may increase the risk of seizures.
  • If you stop taking extended-release lamotrigine for any reason (even for just a few days), do not start taking it again without talking with your healthcare provider. In many cases, you may need to start back at a low dose and slowly work your way up to your previous extended-release lamotrigine dosage.
  • If you have liver or kidney problems, your body may not handle extended-release lamotrigine as well as it should, and you may be at a higher risk for side effects. Talk to your healthcare provider before taking this medicine if you have liver or kidney problems.
  • Extended-release lamotrigine can accumulate in the eyes, potentially causing problems. You should receive regular eye exams while taking this medication.
  • There are several other medications with names similar to extended-release lamotrigine. Medication mix-ups are possible and could be lethal. Always check your tablets to make sure they are the right ones.
  • Extended-release lamotrigine can interact with other medications, including birth control pills (see Drug Interactions With Extended-Release Lamotrigine).
  • Extended-release lamotrigine is considered a pregnancy Category C medication. This means that it may not be safe for pregnant women, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of taking the drug when pregnant (see Lamictal XR and Pregnancy).
  • Extended-release lamotrigine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Lamictal XR and Breastfeeding).
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