Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Lamictal, Lamictal ODT, Lamictal XR
Synonyms :
lamotrigine
Class :
Anticonvulsants
Brand Name :
Lamictal, Lamictal ODT, Lamictal XR
Synonyms :
lamotrigine
Class :
Anticonvulsants
Dosage Forms & Strengths  Â
Tablet (chewable)Â
5 mgÂ
2 mgÂ
25 mgÂ
TabletÂ
200 mgÂ
100 mgÂ
25 mgÂ
150 mgÂ
Tablet (oral disintegrating)Â
50 mgÂ
25 mgÂ
200 mgÂ
100 mgÂ
Tablet (extended release)Â
100 mgÂ
200 mgÂ
25 mgÂ
50 mgÂ
300 mgÂ
250 mgÂ
With enzyme-inducing but without valproic acid
Initial dose of 50 mg orally every day up to 2 weeks after that, take 100 mg/day divided in every 12 hours for 2 weeks
On 5 week and thereafter, it raised by 100 mg/day orally every 1 to 2 Week to 300 to 500 mg/day orally divided in every 12 hours
Lamotrigine XR: begin with 50 mg orally daily, after raised by 100 mg/day orally every week up to week 7 and maintenance dose of 400 to 600 mg orally daily
With valproic acid
Initial dose of 25 mg orally daily up to 2 weeks, after that, on 5 weeks it raised by 25 to 50 mg/day for every 1 to 2 weeks up to 100 to 400 mg/day daily
With valproate alone: take 100 to 200 mg/day orally
Lamotrigine XR: begin with 25, 50 mg, 100 mg and 150 mg orally daily for 2 weeks to maintenance of 200 to 250 mg
Without enzyme-inducing or valproic acid
Initial dose of 25 mg orally daily up to 2 weeks, now again take 50 mg/day orally for other 2 weeks
After 4 weeks may raised by 50 mg/day every 1 to 2 weeks up to 225 to 375 mg/day divided in every 12 hours
Lamotrigine XR: begin with 25 mg orally daily for 2 weeks, then take 50 mg orally for another 2 weeks
Then 100 mg ,150 mg and 200 mg orally daily to maintenance dose of 300 to 400 mg
Taking valproic acid, conversion to immediate-release lamotrigine
Start and titrate to lamotrigine dose of 200 mg/day and lowers valproic acid dose by 500 mg/day at intervals of 1 week along with maintain this dose for another 1 week
Raised lamotrigine dose to 300 mg while valproic acid is reduced to 250 mg/day along with maintain this dose for another 1 week
Discontinue valproic acid
Raised lamotrigine dose by 100 mg/day at weekly intervals to achieve a maintenance dose of 500 mg/day
taking valproic acid, conversion to extended-release lamotrigine
25 mg orally daily: for week 1 to 2 and then in week 3 to 4
50 mg orally daily: in week 5
100 mg orally daily: in week 6
Weeks 7 to 10: take 150 mg orally daily and start valproic acid withdrawal after 5 to 7 weeks to 500mg/day and maintain for 1 week
Week 11: take 200 mg orally daily also reduces valproic acid dose to 250 mg/day for 1 week
Weeks 12 to 23: take 250 to 300 mg orally daily and then discontinue valproic acid
taking neutral AED, conversion to extended-release lamotrigine
take 25 mg orally for weeks 1 to 2
take 50 mg orally for weeks 3 to 4
take 100 mg orally for week 5
take 150 to 200 orally for week 6
from weeks 7 to 23: take 250 to 300 mg orally and start AED withdrawal over 5-weeks by weekly 20% reduction in daily dose
Initial dose of 25 mg orally for 2 weeks
Take 50 mg orally for another 2 weeks
Then take 100 mg orally for 1 week
Take double dose every week to maintenance at 200 mg/day orally
With AED regimen without valproic acid
Initial dose of 50 mg orally for 2 weeks
Take 100 mg/day orally divided every 12 hours for another 2 weeks
Raised it by 100 mg every week to 400 mg/day orally divided every 12 hour
With valproic acid
Initial dose of 25 mg orally for 2 weeks then
Take 25 mg orally for another 2 weeks
Take double dose every week to maintenance at 100 mg/day orally
With enzyme-inducing AED and no valproic acid (age 2 to 12 year)
Initial dose of 0.6 mg/kg/day orally divided in every 12 hours for 2 weeks
Take 1.2 mg/kg/day orally divided in every 12 hours for 2 weeks
At 5 weeks increase by 1.2 mg/kg every 1 to 2 week to maintenance dose of 5 to 15 mg/kg/day orally divided in every 12 hours
Maximum dose of 400 mg/day orally divided in every 12 hours
With valproic acid (age <2 years)
Safety and efficacy not determined
With valproic acid (age 2 to 12 year)
Initial dose of 0.15 mg/kg/day orally then take 0.3 mg/kg/day orally for 2 weeks
On 5 weeks raised by 0.3 mg/kg every 1 to 2 weeks to maintenance dose of 1 to 5 mg/kg/day orally and maximum dose of 200 mg/day subsequently, 1 to 3 mg/kg/day orally with valproic acid only
With valproic acid (age >12 year)
Initial dose of 25 mg orally for 2 weeks and Take 25 mg orally for another 2 weeks
On 5 weeks may raise by 25 to 50 mg/day every 1 to 2 week to 100 to 400 mg/day orally
100 to 200 mg/day orally with valproate alone
Lamotrigine XR: begin 25 mg orally daily for 2 weeks then 50 mg, 100 mg and 150 mg daily; after that 200 to 250 mg orally
Without valproic acid or AED (age <2 year)
Safety and efficacy not determined
Without valproic acid or AED (age 2-12 year)
Initial dose of 0.3 mg/kg/day orally for 2 weeks;
Take 0.6 mg/kg/day orally for another 2 weeks, then
On 5 weeks raise by 0.6 mg/kg every 1 to 2 weeks to maintenance dose of 4.5 to 7.5 mg/kg/day orally and maximum up to 300 mg/day
Without valproic acid or AED (age >12 year)
Initial dose of 25 mg orally for 2 weeks, after that
Take 50 mg/day orally for another 2 weeks;
On 5 weeks may raise by 50 mg/day every 1 to 2 week to 225 to 375 mg/day orally divided in every 12 hours
Lamotrigine XR: begin with 25 mg orally, 50 mg, 100 mg, 150 mg, 200 mg every day for 2 weeks and their after 300 to 400 mg orally
With enzyme-inducing AED and no valproic acid (age 2 to 12 year)
Initial dose of 0.6 mg/kg/day orally divided in every 12 hours for 2 weeks
Take 1.2 mg/kg/day orally divided in every 12 hours for 2 weeks
At 5 weeks increase by 1.2 mg/kg every 1 to 2 week to maintenance dose of 5 to 15 mg/kg/day orally divided in every 12 hours
Maximum dose of 400 mg/day orally divided in every 12 hours
With valproic acid (age <2 years)
Safety and efficacy not determined
With valproic acid (age 2 to 12 year)
Initial dose of 0.15 mg/kg/day orally then take 0.3 mg/kg/day orally for 2 weeks
On 5 weeks raised by 0.3 mg/kg every 1 to 2 weeks to maintenance dose of 1 to 5 mg/kg/day orally and maximum dose of 200 mg/day
subsequently, 1 to 3 mg/kg/day orally with valproic acid only
With valproic acid (age >12 year)
Initial dose of 25 mg orally for 2 weeks and Take 25 mg orally for another 2 weeks
On 5 weeks may raise by 25 to 50 mg/day every 1 to 2 week to 100 to 400 mg/day orally
100 to 200 mg/day orally with valproate alone
Lamotrigine XR: begin 25 mg orally daily for 2 weeks then 50 mg, 100 mg and 150 mg daily; after that 200 to 250 mg orally
Without valproic acid or AED (age <2 year)
Safety and efficacy not determined
Without valproic acid or AED (age 2-12 year)
Initial dose of 0.3 mg/kg/day orally for 2 weeks;
Take 0.6 mg/kg/day orally for another 2 weeks, then
On 5 weeks raise by 0.6 mg/kg every 1 to 2 weeks to maintenance dose of 4.5 to 7.5 mg/kg/day orally and maximum up to 300 mg/day
Without valproic acid or AED (age >12 year)
Initial dose of 25 mg orally for 2 weeks, after that
Take 50 mg/day orally for another 2 weeks;
On 5 weeks may raise by 50 mg/day every 1 to 2 week to 225 to 375 mg/day orally divided in every 12 hours
Lamotrigine XR: begin with 25 mg orally, 50 mg, 100 mg, 150 mg, 200 mg every day for 2 weeks and their after 300 to 400 mg orally
With enzyme-inducing AED and no valproic acid (age 2 to 12 year)
Initial dose of 0.6 mg/kg/day orally divided in every 12 hours for 2 weeks
Take 1.2 mg/kg/day orally divided in every 12 hours for 2 weeks
At 5 weeks increase by 1.2 mg/kg every 1 to 2 week to maintenance dose of 5 to 15 mg/kg/day orally divided in every 12 hours
Maximum dose of 400 mg/day orally divided in every 12 hours
With valproic acid (age <2 years)
Safety and efficacy not determined
With valproic acid (age 2 to 12 year)
Initial dose of 0.15 mg/kg/day orally then take 0.3 mg/kg/day orally for 2 weeks
On 5 weeks raised by 0.3 mg/kg every 1 to 2 weeks to maintenance dose of 1 to 5 mg/kg/day orally and maximum dose of 200 mg/day
subsequently, 1 to 3 mg/kg/day orally with valproic acid only
With valproic acid (age >12 year)
Initial dose of 25 mg orally for 2 weeks and Take 25 mg orally for another 2 weeks
On 5 weeks may raise by 25 to 50 mg/day every 1 to 2 week to 100 to 400 mg/day orally
100 to 200 mg/day orally with valproate alone
Lamotrigine XR: begin 25 mg orally daily for 2 weeks then 50 mg, 100 mg and 150 mg daily; after that 200 to 250 mg orally
Without valproic acid or AED (age <2 year)
Safety and efficacy not determined
Without valproic acid or AED (age 2-12 year)
Initial dose of 0.3 mg/kg/day orally for 2 weeks;
Take 0.6 mg/kg/day orally for another 2 weeks, then
On 5 weeks raise by 0.6 mg/kg every 1 to 2 weeks to maintenance dose of 4.5 to 7.5 mg/kg/day orally and maximum up to 300 mg/day
Without valproic acid or AED (age >12 year)
Initial dose of 25 mg orally for 2 weeks, after that
Take 50 mg/day orally for another 2 weeks;
On 5 weeks may raise by 50 mg/day every 1 to 2 week to 225 to 375 mg/day orally divided in every 12 hours
Lamotrigine XR: begin with 25 mg orally, 50 mg, 100 mg, 150 mg, 200 mg every day for 2 weeks and their after 300 to 400 mg orally
Dosage Forms & Strengths  Â
Tablet (chewable)Â
5 mgÂ
2 mgÂ
25 mgÂ
TabletÂ
100 mgÂ
25 mgÂ
200 mgÂ
150 mgÂ
Tablet (oral disintegrating)Â
50 mgÂ
25 mgÂ
200 mgÂ
100 mgÂ
Tablet (extended release)Â
100 mgÂ
200 mgÂ
25 mgÂ
50 mgÂ
250 mgÂ
300 mgÂ
Taking valproic acid, conversion to immediate-release lamotrigine (age>16 year)
Start and titrate to lamotrigine dose of 200 mg/day and lowers valproic acid dose by 500 mg/day at intervals of 1 week along with maintain this dose for another 1 week
Raised lamotrigine dose to 300 mg while valproic acid is reduced to 250 mg/day along with maintain this dose for another 1 week
Discontinue valproic acid
Raised lamotrigine dose by 100 mg/day at weekly intervals to achieve a maintenance dose of 500 mg/day
taking valproic acid, conversion to extended-release lamotrigine (age>13 year)
25 mg orally daily: for week 1 to 2 and then in week 3 to 4
50 mg orally daily: in week 5
100 mg orally daily: in week 6
Weeks 7 to 10: take 150 mg orally daily and start valproic acid withdrawal after 5 to 7 weeks to 500mg/day and maintain for 1 week
Week 11: take 200 mg orally daily also reduces valproic acid dose to 250 mg/day for 1 week
Weeks 12 to 23: take 250 to 300 mg orally daily and then discontinue valproic acid
taking neutral AED, conversion to extended-release lamotrigine (age>13 year)
take 25 mg orally for weeks 1 to 2
take 50 mg orally for weeks 3 to 4
take 100 mg orally for week 5
take 150 to 200 orally for week 6
from weeks 7 to 23: take 250 to 300 mg orally and start AED withdrawal over 5-weeks by weekly 20% reduction in daily dose
Refer to adult dosingÂ
may have an increased arrhythmogenic effect when combined with lamotrigine
may have an increased arrhythmogenic effect when combined with lamotrigine
may have an increased arrhythmogenic effect when combined with lamotrigine
may have an increased arrhythmogenic effect when combined with lamotrigine
may have an increased arrhythmogenic effect when combined with lamotrigine
cyproterone and ethinyl estradiolÂ
may diminish the serum concentration when combined
spironolactone and hydrochlorothiazide
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may enhance the toxic effects of the other by pharmacodynamic synergism
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
may increase the adverse or toxic effect of anti-psychotic agents
it increases the concentration of metformin in the serum
it may enhance the risk of QTc prolongation when combined with amifampridine
The potential for increased CNS depression risk or seriousness occurs when lamotrigine is used together with pipecuronium
The potential for CNS depression may enhanced when lamotrigine is used together with fencamfamin
When lamotrigine is used together with niaprazine, the risk or seriousness of CNS depression is enhanced
When lamotrigine is used together with levosulpiride, the risk or seriousness of CNS depression is enhanced
When lamotrigine is used together with adenine, this leads to a reduction in the lamotrigine’s metabolism
it decreases the concentration of progestins in serum
may enhance the serum concentration when combined
the efficacy of lamotrigine may be reduced by norethisterone due to increased hepatic clearance rate
the risk of QTc prolongation may be increased
Actions and SpectrumÂ
lamotrigine’s exact mode of action is unknown, although it is believed to involve blocking the release of certain neurotransmitters like glutamate and aspartate, which can result in seizures and mood swings.Â
lamotrigine’s therapeutic range includes treating epileptic patients’ focal (partial) and generalised seizures. Additionally, it is used to stop both manic and depressed mood swings in persons with bipolar illness.Â
Frequency not defined Â
DepressionÂ
Flu syndromeÂ
InfectionÂ
Emotional labilityÂ
NauseaÂ
CoughÂ
IncoordinationÂ
PruritusÂ
ConstipationÂ
DiarrheaÂ
DyspepsiaÂ
PalpitationsÂ
VomitingÂ
VaginitisÂ
NystagmusÂ
Decreased memoryÂ
ArthralgiaÂ
Neck painÂ
AnxietyÂ
ChillsÂ
RashÂ
AmenorrheaÂ
Hot flashesÂ
Abdominal painÂ
MalaiseÂ
Seizure exacerbationÂ
VertigoÂ
1-10%Â
Dermatitis (2-5%)Â
Peripheral edema (2-5%)Â
Abnormal thoughts (1-5%)Â
Tremor (4%)Â
Increased libido (2-5%)Â
Rectal hemorrhage (2-5%)Â
Suicidal ideation (2-5%)Â
Urinary frequency (1-5%)Â
Edema (1-5%)Â
Fever (1-5%)Â
Migraine (1-5%)Â
Fatigue (8%)Â
Insomnia (6-10%)Â
Chest pain (5%)Â
Dry skin (2-5%)Â
Weakness (2-5%)Â
Agitation (1-5%)Â
Dysarthria (1-5%)Â
>10%Â
Somnolence (14%)Â
Ataxia (22%)Â
Blurred vision (16-20%)Â
Dizziness (38%)Â
Diplopia (26-30%)Â
Headache (29%)Â
Rhinitis (11-15%)Â
Post marketing reportsÂ
EsophagitisÂ
Aseptic meningitisÂ
PancreatitisÂ
AggressionÂ
Progressive immunosuppressionÂ
Cardiac rhythm and conduction abnormalitiesÂ
VasculitisÂ
ApneaÂ
Exacerbation of Parkinsonian symptoms in patients with pre-existing Parkinson’s diseaseÂ
RhabdomyolysisÂ
Lupus-like reactionÂ
Agranulocytosis, hemolytic anemiaÂ
Black Box WarningÂ
For the possibility of severe skin reactions such Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), lamotrigine carries a black box warning. Â
lamotrigine should be stopped as soon as a rash appears, unless it is obvious that the rash is unrelated to the medicine, according to the caution.Â
Contraindication/Caution:Â
Contraindication:Â
Caution:Â
Pregnancy warnings:    Â
Pregnancy category: N/AÂ
Lactation: Excretion into human milk is knownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
PharmacologyÂ
lamotrigine is an anticonvulsant or antiepileptic medicine that is structurally distinct from other antiepileptic medications. Although the precise mode of action of lamotrigine is not entirely known, it is believed to function by preventing the brain’s excitatory neurotransmitter glutamate from being released. lamotrigine assists in lowering the probability of seizures and mood swings in this way.Â
PharmacodynamicsÂ
It is thought that lamotrigine works by altering voltage-gated sodium channels, which are essential for the development and transmission of action potentials in neurons. lamotrigine specifically suppresses persistent, recurrent neuronal activation, which can aid in halting the progression of seizure activity in the brain.Â
PharmacokineticsÂ
Absorption  Â
Following oral treatment, lamotrigine is well absorbed, reaching peak plasma concentrations in 1.4 to 4.8 hours. lamotrigine’s absorption may be slowed down by food, although this does not seem to have an impact on how much is absorbed overall. lamotrigine is also offered in orally disintegrating pills, which are more quickly absorbed than normal tablets and disintegrate swiftly in the mouth.Â
DistributionÂ
The volume of distribution of around 1.4 L/kg, lamotrigine is widely dispersed throughout the body. Most of the medicine between 55% and 68% is bonded to plasma proteins, especially albumin. The drug is largely protein-bound.Â
MetabolismÂ
lamotrigine undergoes most of its metabolism in the liver, mostly through glucuronidation, which entails the addition of a glucuronic acid molecule to the medication to make it more soluble in water and simpler to excrete from the body. The metabolism of lamotrigine may potentially involve additional metabolic processes including oxidation and N-glucuronidation in a modest capacity.Â
Elimination and excretionÂ
Approximately 94% of the dosage of lamotrigine and its metabolites are excreted in the urine within 7 days of treatment. The medication is partially excreted in the feces. The lamotrigine’s half-life of elimination in healthy persons is around 25 to 35 hours, however it may be longer in patients with hepatic impairment.Â
Administration: Â
lamotrigine comes in a variety of forms, including chewable, immediate-release, and extended-release pills as well as tablets that dissolve in the mouth. Â
lamotrigine can be taken with or without meals, however it may take longer for the medicine to reach its peak plasma concentration if taken with food. lamotrigine’s extended-release medication needs to be taken whole; it shouldn’t be crushed or chewed.Â
Patient information leafletÂ
Generic Name: lamotrigineÂ
Why do we use lamotrigine?Â
Generalised seizures, partial seizures, and Lennox-Gastaut syndrome can all be treated with lamotrigine, an antiepileptic drug. It can be used either by alone or in conjunction with other antiepileptic medications.Â
lamotrigine is used for the maintenance treatment of bipolar disorder to postpone the onset of mood episodes (depression, mania, hypomania, and mixed episodes) in patients receiving treatment for acute mood episodes with conventional medication.Â
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