Can I take lamotrigine after ibuprofen



Characteristics
Name (INN) Lamotrigine
Impact group

Anticonvulsant

Trade names
  • Bipolam®
  • Elmendos®
  • Lamapol®
  • Lamictal®
classification
ATC code AX09
CAS number 84057-84-1
Prescription Required: Yes

  Lamotrigine is a drug from the group of anti-epileptic drugs that has been approved since 1993 and is suitable for patients aged 12 and over. In addition to treating epilepsy, it is also used for mood disorders. Lamotrigine was developed and first marketed by GlaxoSmithKline. It has been available as a generic since June 2005.

pharmacology

Pharmacodynamics (mechanism of action)

Lamotrigine blocks sodium and voltage-dependent calcium channels in nerve cells and prevents the release of the excitatory neurotransmitters aspartate and glutamate. This means that stimuli can only spread to a reduced extent from one nerve cell to another.

Areas of application

In epilepsy treatment, 40% - 60% are free from seizures. However, experience shows that the effectiveness in myoclonus can be reduced.

In addition to the treatment of epilepsy, it is mainly used for the prophylaxis of recurrent depression and of depressive states in the case of bipolar disorder. This effect has also been well documented in controlled studies. In the treatment of manias, on the other hand, it shows rather minor effects. Lamotrigine has a mood-stabilizer and thus joins the phase prophylactic drugs.

In addition, in a study of stroke patients, a reduction in pain was observed in 30% of those involved. Good efficacy in HIV-associated polyneuropathy is also described.

In recent times, neurologists have often used the remedy against migraines with great success - but not against headaches, but in cases where the aura (neurological deficits, symptoms of paralysis, visual field defects due to migraines) is in the foreground.

Tolerability, known side effects

Lamotrigine is usually well tolerated. If the dose is increased too quickly, dangerous skin and mucous membrane reactions (exanthema, exfoliative dermatitis, Stevens-Johnson syndrome) can occur. In rare cases, double vision, dizziness, headaches, nausea, disorders in the movement sequence (ataxia), muscle tremors (tremor), Lyell's syndrome ("scalded skin syndrome"), agranulocytosis, sleep disorders or even behavioral disorders can occur. In 3% of the cases, however, an accumulation of seizures can occur!

If none of the side effects occurred after 8 weeks of treatment, it can be assumed that the drug is tolerated. Except when switching from another medication, taking other medications at the same time and having milder symptoms shortly after an increased dose.

This active ingredient appears to be suitable for pregnant women, but an increased risk of embryonic malformations of the mouth and palate has been found in connection with the use of lamotrigine during early pregnancy.

Interactions

The pain reliever paracetamol can increase the breakdown of lamotrigine in the body. Painkillers with the active ingredient ibuprofen are an alternative.

Malaria therapy or prophylaxis can also reduce the effectiveness of lamotrigine or the anti-malarial agent.

Therapy with lamotrigine and other anti-epileptic drugs can lead to increased side effects. With carbamazepine therapy, lamotrigine is broken down more quickly because carbamazepine is an enzyme inducer. Therefore, more substance has to be taken. With valproic acid therapy (inhibitor), lamotrigine is broken down more slowly. To avoid side effects, lamotrigine in combination with valproic acid must be added much more slowly. The same applies to drugs with the active ingredients phenytoin, phenobarbital and primidone.

The lamotrigin concentration in the plasma is disturbed by the use of the contraceptive pill. Taking the pill reduces lamotrigine levels by up to 50%. There may be more seizures. Stopping the pill causes the level to rise, so the rate of side effects increases. Conversely, lamotrigine can also interfere with the effectiveness of hormonal contraceptives.

dosage

In adults, the dose is gradually increased by 25 mg every 14 days until a daily dose of 100 mg to 400 mg (in rare cases up to 700 mg) is reached. It is taken in two doses throughout the day. Particular care should be taken with the dose when taking valproic acid at the same time. (see interactions). The maintenance dose is around 200 mg.

Tablets with 25 mg, 50 mg, 100 mg and 200 mg and packaging sizes of 50, 100 and 200 tablets are common.

literature

  • Brunnhuber, S., Frauenknecht, S. & Lieb, K. (2005). Intensive course in psychiatry and psychotherapy. Urban & Fischer: Munich. ISBN 3-437-42131-X

Categories: Chemical Compound | Antidepressant | Drug