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When taking lamotrigine (Lamictal), it's crucial to be aware of several safety warnings and precautions to ensure safe use and minimize potential risks. Below is a summary of key safety information:

• Severe Skin Reactions and Allergic Reactions: Lamotrigine can cause serious skin rashes, which may require hospitalization. The risk is higher if taken in conjunction with valproic acid, divalproex, or if the dosage is too high or increased too quickly. Skin reactions are more frequent in children and typically occur within 2 to 8 weeks of starting the medication. Seek immediate medical attention if you notice a rash, blistering, or peeling skin, sores, swelling, or difficulty breathing.

• Overactive Immune System: Rarely, the medication may cause hemophagocytic lymphohistiocytosis (HLH), a life-threatening condition. Symptoms may emerge between 8 to 24 days after beginning treatment and include fever, rash, abdominal pain, brown urine, or jaundice. Immediate medical care is essential if these symptoms appear.

• Irregular Heartbeat: Lamotrigine can cause irregular heart rhythms, particularly in those with a history of heart disease or who take other heart-affecting medications. Inform your healthcare provider if you have any heart conditions to discuss the potential risks and benefits.

• Suicidal Behavior and Thoughts: Like many antiseizure drugs, lamotrigine may increase the risk of suicidal thoughts or behaviors, especially if you have a history of depression or suicidal thoughts. Inform your friends and family to monitor any changes in mood or behavior and contact your healthcare provider if suicidal thoughts occur.

• Meningitis (Brain Inflammation): Although rare, lamotrigine may increase the risk of meningitis. Symptoms can appear from 1 to 45 days after starting treatment, including headache, stiff neck, fever, rash, and confusion. Seek medical attention immediately if these symptoms develop.

• Withdrawal Seizures: Abruptly stopping lamotrigine can increase the risk of seizures. Consult your healthcare provider before discontinuing use, and follow their guidance to taper the dosage gradually.

• Potential Eye Problems: Long-term use of lamotrigine might be linked to eye problems due to its interaction with melanin. If you experience changes in vision, notify your healthcare provider for an examination.

• Drug Interactions: Lamotrigine can interact with other medications, affecting its effectiveness and increasing side effects. It may also alter the clearance of other drugs from the body, enhancing their side effects. Discuss all medications you take with your healthcare provider to manage interactions effectively.

In an emergency, such as an overdose, contact medical services immediately for assistance. Always follow your healthcare provider's instructions and report any adverse reactions or concerns promptly.

Common side effects:

• dizziness
• headache
• nausea
• drowsiness
• double vision
• loss of coordination
• blurry vision
• stuffy nose
• sore throat

• rash

  Less common but important to monitor:

• vomiting
• tremor
• feeling tired
• diarrhea

• sleep disturbances

  Serious side effects:

• fainting
• irregular or pounding heartbeat
• unusual bruising or bleeding
• stiff neck
• vision problems
• muscle pain or weakness
• signs of kidney problems like changes in urine output
• mental health changes such as depression or suicidal thoughts

Interactions with high risk of serious adverse effects and should be avoided:

• Dofetilide
• Orlistat

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Hormonal birth control (such as pills, patches)
• Estrogens
• Phenobarbital
• Primidone
• Valproic Acid
• Rifampin
• Ritonavir
• Atazanavir
• Calcifediol
• Carbamazepine
• Cenobamate
• Desmopressin
• Ezogabine
• Fosphenytoin
• Lopinavir
• Phenytoin
• Oxcarbazepine
• Rufinamide

Interactions with low risk that usually do not require a change in therapy:

• Alcohol
• Marijuana (cannabis)
• Antihistamines (such as cetirizine, diphenhydramine)
• Drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem)
• Muscle relaxants
• Opioid pain relievers (such as codeine)
• Desogestrel
• Dienogest
• Drospirenone
• Escitalopram
• Estradiol
• EthinylEstradiol
• Ethynodiol
• Gestodene
• Ginkgo
• Ginseng
• Levonorgestrel
• Mestranol
• Methsuximide
• Nomegestrol
• Norethindrone
• Norgestimate
• Norgestrel
• Risperidone
• Sertraline