Lamotrigine


Generic Medicine Info
Indications and Dosage
Oral
Bipolar I disorder
Adult: As immediate-release: Monotherapy or adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, increased to 50 mg daily for 2 weeks, then 100 mg daily for 1 week, then to 200 mg daily (usual target dose). Daily doses from week 3 may be given as a single or in 2 divided doses. Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, increased to 25 mg once daily for 2 weeks, then 50 mg daily for 1 week, then to 100 mg daily (usual target dose). Max: 200 mg daily. Daily doses from week 5 may be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, increased to 50 mg bid for 2 weeks, then 100 mg bid for 1 week, then 150 mg bid for 1 week. If needed, may increase to 200 mg bid (usual target dose). Increase doses based on response and tolerability. Dosage adjustments may be required if other drugs are added to or withdrawn from therapy (refer to detailed product guideline).

Oral
Generalised tonic-clonic seizures
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. Adjunctive therapy with valproate (regardless of any concomitant medications): Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid for 2 weeks, then increase by Max of 100 mg every 1-2 weeks. Usual maintenance: 200-400 mg daily in 2 divided doses, may increase up to 700 mg daily if necessary. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Increase doses based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate (regardless of any concomitant drugs): Initially, 0.15 mg/kg once daily for 2 weeks, then 0.3 mg/kg once daily for 2 weeks, then increase by Max of 0.3 mg/kg every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily as a single or in 2 divided doses. Max: 200 mg daily. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg every 1-2 weeks. Usual maintenance: 1-10 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).

Oral
Partial seizures
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. As immediate/extended-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks. Doses may then be increased by Max of 25-50 mg daily every 1-2 weeks (immediate-release); or increased to 50 mg once daily at week 5, 100 mg once daily at week 6, and 150 mg once daily at week 7 (extended-release). Usual maintenance: 100-200 mg daily as a single or in 2 divided doses (immediate-release); 200-250 mg once daily (extended-release). Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid (immediate-release) or 100 mg once daily (extended-release) for 2 weeks. Doses may then be increased by Max of 100 mg daily every 1-2 weeks (immediate-release) or weekly for the next 3 weeks (extended-release). Usual maintenance: 200-400 mg daily or 300-500 mg daily in 2 divided doses (immediate-release); 400-600 mg once daily (extended-release). If needed, may increase up to 700 mg daily (immediate-release). Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks. Doses may then be increased by Max of 50-100 mg daily every 1-2 weeks (immediate-release), or by 50 mg weekly for the next 3 weeks (extended-release). Usual maintenance: 100-200 mg daily as a single or in 2 divided doses or 225-375 mg daily in 2 divided doses (immediate-release); 300-400 mg once daily (extended-release). Increase doses based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years As immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).

Oral
Primary generalised tonic-clonic seizures
Adult: As extended-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks; increase to 50 mg once daily at week 5, 100 mg once daily at week 6, then 150 mg once daily at week 7. Usual maintenance: 200-250 mg once daily. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 100 mg once daily for 2 weeks; increase to 200 mg once daily at week 5, 300 mg once daily at week 6, then 400 mg once daily at week 7. Usual maintenance: 400-600 mg once daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks; increase to 100 mg once daily at week 5, then 150 mg once daily at week 6, then 200 mg once daily at week 7. Usual maintenance: 300-400 mg once daily. Alternative dosing for immediate-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily (with valproate alone) or 100-400 mg daily (with valproate and other drugs that induce glucuronidation) as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg daily for 2 weeks, then 100 mg daily in 2 divided doses for 2 weeks, then increase by Max of 100 mg daily every 1-2 weeks. Usual maintenance: 300-500 mg daily in 2 divided doses. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg daily for 2 weeks, then increase by Max of 50 mg daily every 1-2 weeks. Usual maintenance: 225-375 mg daily in 2 divided doses. Increase dose based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years Alternative dosing for immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily, or 1-3 mg/kg daily (with valproate alone). Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily for 2 weeks, then 1.2 mg/kg daily for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily. Max: 400 mg daily. Doses to be given in 2 divided doses. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily as single or in 2 divided doses for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Usual maintenance: 4.5-7.5 mg/kg daily. Max: 300 mg daily. Doses from week 3 may be given in 2 divided doses. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years As immediate/extended-release: Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).

Oral
Typical absence seizure
Child: 2-12 years As immediate-release: Monotherapy: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg every 1-2 weeks. Usual maintenance: 1-10 mg/kg daily, may increase up to 15 mg/kg daily if necessary. Doses to be given as a single or in 2 divided doses. Increase dose based on response and tolerability.

Oral
Seizures associated with the Lennox-Gastaut syndrome
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid for 2 weeks, then increase by Max of 100 mg daily every 1-2 weeks. Usual maintenance: 200-400 mg daily or 300-500 mg daily in 2 divided doses. If needed, may increase up to 700 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses or 225-375 mg daily in 2 divided doses. Increase dose based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Special Patient Group
In women starting estrogen-containing oral contraceptives and already taking stable doses of lamotrigine without other inducers of glucuronidation: Maintenance dose may be increased by as much as 2-fold. Recommended dose (from the time that the contraceptive is started): Increase by 50-100 mg daily every week according to clinical response. Refer to detailed product guideline for further information.

In women discontinuing estrogen-containing oral contraceptives and already taking stable doses of lamotrigine without other inducers of glucuronidation: Maintenance dose may be decreased by as much as 50%. Gradually decrease the daily dose by 50-100 mg weekly for over a period of 2 or 3 weeks (at a Max rate of 25% of total daily dose each week), unless clinical response or lamotrigine levels indicate otherwise.
Renal Impairment
Dosage adjustment may be needed.
Hepatic Impairment
Bipolar I disorder; Partial seizures; Seizures associated with the Lennox-Gastaut syndrome:
Moderate (Child-Pugh class B): Reduce dose by approx 50%. Severe (Child-Pugh class C): Reduce dose by approx 75%. Alternatively, in patients with moderate or severe cases (Child-Pugh class B or C) without ascites, reduce dose by approx 25%; in patients with severe cases with ascites, reduce dose by approx 50%. Dose reductions include the initial, escalation and maintenance doses. Adjust the escalation and maintenance doses according to clinical response. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).

Generalised tonic-clonic seizures:
Moderate (Child-Pugh class B): Reduce by approx 50%. Severe (Child-Pugh class C): Reduce by approx 75%.

Primary generalised tonic-clonic seizures:
Moderate or severe (Child-Pugh class B or C) without ascites: Reduce by approx 25%. Severe with ascites: Reduce by approx 50%. Decrease the initial, escalation and maintenance doses. Adjust the escalation and maintenance doses according to clinical response.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity (e.g. acute urticaria, rash, extensive pruritus, angioedema, mucosal ulceration) to lamotrigine.
Special Precautions
Patient with a history of allergy or rash to other antiepileptic drugs; clinically important structural or functional heart disease (e.g. heart failure, MI, Brugada syndrome or other Na channelopathies, multiple risk factors for coronary heart disease; valvular, congenital or ischaemic heart disease, conduction system disease, ventricular arrhythmias); history of suicidal behaviours or thoughts, or exhibiting a significant degree of suicidal ideation before treatment initiation. Women taking estrogen-containing oral contraceptives. Not indicated for the treatment of acute manic or depressive episodes. Avoid abrupt withdrawal (unless serious reactions occur). Significant renal and moderate to severe hepatic impairment. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Suicidal ideation and behaviour, CNS depression, exacerbation of myoclonic seizures, aseptic meningitis, photosensitivity reactions, rash; may accumulate and cause toxicity in the eye and other melanin-rich tissues (long-term use). Rarely, blood dyscrasias (e.g. aplastic anaemia, pancytopenia, neutropenia, leucopenia, thrombocytopenia).
Cardiac disorders: Chest pain.
Eye disorders: Nystagmus, diplopia, blurred vision.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, xerostomia, abdominal pain, constipation, dyspepsia.
General disorders and administration site conditions: Fatigue, pain, fever, flu syndrome.
Hepatobiliary disorders: Rarely, hepatic dysfunction.
Infections and infestations: Infection.
Investigations: Weight gain or loss. Rarely, increased LFTs.
Metabolism and nutrition disorders: Anorexia.
Musculoskeletal and connective tissue disorders: Arthralgia, back or neck pain.
Nervous system disorders: Headache, dizziness, tremor, ataxia, incoordination, somnolence, exacerbation of Parkinson’s disease.
Psychiatric disorders: Aggression, irritability, insomnia, agitation.
Reproductive system and breast disorders: Dysmenorrhoea, vaginitis.
Respiratory, thoracic and mediastinal disorders: Rhinitis, pharyngitis, increased cough.
Potentially Fatal: May cause cardiac rhythm and conduction abnormalities (e.g. slow ventricular conduction [widen QRS], arrhythmia, typical Brugada ECG pattern) in patients with heart disease. Rarely, serious skin rashes (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis), haemophagocytic lymphohistiocytosis (HLH); multiorgan hypersensitivity reactions or drug reaction with eosinophilia and systemic symptoms (DRESS) causing hepatic or multiorgan failure, or disseminated intravascular coagulation.
Patient Counseling Information
This drug may cause dizziness, drowsiness and double vision; if affected, do not drive or operate machinery. Avoid excessive exposure to sunlight or UV lights; use protective clothing and sunscreen when going outdoors.
Monitoring Parameters
Monitor the serum levels of concomitant anticonvulsants; lamotrigine plasma concentrations (as clinically indicated); LFTs and renal function; ECG before starting treatment in at-risk patients. Closely assess for signs and symptoms of hypersensitivity reactions (particularly skin rash), blood dyscrasias, and aseptic meningitis; clinical worsening (in bipolar disorder), depression, suicidal thoughts, and unusual mood or behavioural changes particularly during treatment initiation and dose changes.
Overdosage
Symptoms: Nystagmus, ataxia, impaired consciousness, seizures (including tonic-clonic seizures), intraventricular conduction delay, and coma. Management: Supportive treatment. Administer activated charcoal or laxative, and perform gastric lavage or emesis if indicated. Closely observe patient and frequently monitor vital signs.
Drug Interactions
Valproate significantly inhibits lamotrigine glucuronidation resulting in the increased serum concentrations and toxic effects of lamotrigine. Concomitant use with drugs that induce lamotrigine glucuronidation such as phenytoin, carbamazepine, primidone, phenobarbital, rifampicin, lopinavir/ritonavir, atazanavir/ritonavir, and estrogen-containing oral contraceptives (e.g. ethinylestradiol/levonorgestrel) leads to decreased plasma concentrations of lamotrigine. May cause CNS effects (e.g. blurred vision, diplopia, dizziness, ataxia) and nausea with carbamazepine. May increase the concentrations of topiramate. Risk of arrhythmias may be increased further with other Na channel blockers. May increase the plasma levels of certain organic cationic transporter 2 (OCT2) substrates.
Food Interaction
May potentiate the CNS depressant effects of alcohol.
Lab Interference
May cause false-positive results with some rapid urine drug screening, especially for phencyclidine.
Action
Description: Lamotrigine is a phenyltriazine anticonvulsant agent with inhibitory effects on dihydrofolate reductase in vitro. The exact anticonvulsant mechanism of action is not yet known; however, in vitro pharmacological studies suggest that it blocks voltage-sensitive Na channels resulting in the stabilisation of neuronal membranes and subsequent inhibition of the release of excitatory amino acid neurotransmitters (e.g. glutamate, aspartate). In bipolar disorder, its precise mechanism has not been established.
Pharmacokinetics:
Absorption: Rapidly and completely absorbed from the gastrointestinal tract (immediate-release). Absolute bioavailability: 98% (immediate-release). Time to peak plasma concentration: Based on the adjunct treatment: Approx 1-5 hours (immediate-release); 4-11 hours (extended-release).
Distribution: Widely distributed in the body. Crosses the placenta and enters breast milk. Volume of distribution: 1.1 L/kg (range: 0.9-1.3 L/kg). Plasma protein binding: Approx 55%, mainly to albumin.
Metabolism: Extensively metabolised in the liver by uridine 5’-diphospho (UDP)-glucuronyl transferases (UGT) primarily via glucuronidation into 2-N-glucuronide conjugate (major inactive metabolite).
Excretion: Mainly via urine (94%; approx 90% as glucuronide conjugates, approx 10% as unchanged drug); faeces (approx 2%). Elimination half-life: 24-35 hours.
Chemical Structure

Chemical Structure Image
Lamotrigine

Source: National Center for Biotechnology Information. PubChem Database. Lamotrigine, CID=3878, https://pubchem.ncbi.nlm.nih.gov/compound/Lamotrigine (accessed on Jan. 22, 2020)

Storage
Store between 15-30°C. Protect from light and moisture.
MIMS Class
Anticonvulsants / Antipsychotics
ATC Classification
N03AX09 - lamotrigine ; Belongs to the class of other antiepileptics.
References
Anon. Lamotrigine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 07/04/2021.

Anon. Lamotrigine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/04/2021.

Buckingham R (ed). Lamotrigine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/04/2021.

Joint Formulary Committee. Lamotrigine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/04/2021.

Lamictal 100 mg Chewable/Dispersible Tablets (The Wellcome Foundation Ltd). MHRA. https://products.mhra.gov.uk. Accessed 07/04/2021.

Lamictal Film Coated Extended-Release Tablet (GlaxoSmithKline LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 07/04/2021.

Lamictal Tablet, Tablet for Suspension, Orally-Disintegrating Tablet (GlaxoSmithKline LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 07/04/2021.

Lamictal Tablets and Dispersible Tablets (GlaxoSmithKline Pharmaceutical Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 07/04/2021.

Lamotrigine Consilient 25 mg Tablets (Consilient Health Limited). MHRA. https://products.mhra.gov.uk. Accessed 07/04/2021.

Studies Show Increased Risk of Heart Rhythm Problems with Seizure and Mental Health Medicine Lamotrigine (Lamictal) in Patients with Heart Disease. U.S. FDA Safety Alert. https://www.fda.gov. Accessed 07/04/2021.

Disclaimer: This information is independently developed by MIMS based on Lamotrigine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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