Depakote Sprinkles and Lamotrigine

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Before using lamoTRIgine, tell your doctor if you also use divalproex sodium. This combination may cause skin rash, restlessness, seizures, tremors, muscle weakness, and staggering walk. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests in order to safely take both medications together. Avoid driving until you know how the medications will affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with valproic acid has been shown to significantly increase the plasma concentrations of lamotrigine and the risk of potentially serious and life-threatening rash induced by lamotrigine, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Severe, disabling tremors and ataxia have also been reported. The mechanism is competitive inhibition of lamotrigine glucuronidation by valproic acid. Pharmacokinetic data indicate that valproic acid can more than double the elimination half-life of lamotrigine, whether given with or without enzyme-inducing antiepileptic drugs (EIAEDs) such as carbamazepine, phenytoin, and phenobarbital. In a study of eight patients treated with lamotrigine, half of whom also received EIAEDs, valproic acid 200 mg/day and 1000 mg/day (each for 3 weeks) increased the dose-corrected area under the plasma concentration-time curve (AUC) of lamotrigine by an average of 84% and 160%, respectively. Corresponding lamotrigine half-life increased by an average of 37% and 150%. Additive or synergistic pharmacodynamic effects may also contribute to the interaction, which some investigators suggest is responsible in some patients for enhanced antiepileptic efficacy beyond that attained from mere increases in plasma lamotrigine levels. Lamotrigine appears to have negligible to minor effects on the pharmacokinetics of valproic acid.

MANAGEMENT: When coadministered with valproic acid, the dosage of lamotrigine should be half that required in the absence of valproic acid. Patients should be advised to promptly notify their physician if they experience early manifestations of hypersensitivity such as fever, angioedema, and lymphadenopathy, even if a rash is not evident. Lamotrigine should be discontinued if an alternative etiology for these symptoms cannot be established. Likewise, the drug should be discontinued at the first sign of rash, unless the rash is clearly not drug-related.

Depakote Sprinkles

Generic Name: divalproex sodium

Brand name: Depakote ER, Depakote Sprinkles, Depakene, Depacon, Depakote

Synonyms: Depakote Capsules

What is Depakote Sprinkles?

Lamotrigine

Generic Name: lamotrigine

Brand name: Lamictal, Lamictal ODT, Lamictal XR, Subvenite, Lamictal CD, LaMICtal Starter Kit, LaMICtal ODT Patient Titration Kit, LaMICtal XR Patient Titration Kit, LamoTRIgine Starter Kit, Subvenite Starter Kit, Lamictal, Lamictal ODT, Lamictal XR

Synonyms: LamoTRIgine

What is Lamotrigine?