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Table 4Conversion From Adjunctive Therapy With Valproate to Monotherapy With LAMICTAL in Patients Aged 16 Years and Older With Epilepsy.
In healthy volunteers not receiving any other medications and given single dosesthe plasma concentrations of lamotrigine increased in direct proportion to the dose administered over the range of 50 to 400 mgIn 2 small studiesn7 and 8of patients with epilepsy who were maintained on other AEDsthere also was a linear relationship between dose and lamotrigine plasma concentrations at steady state following doses of 50 to 350 mg twice daily.
Smaller starting doses and slower dose escalations than those used in clinical trials are recommended because of the suggestion that the risk of rash may be decreased by smaller starting doses and slower dose escalationsThereforemaintenance doses will take longer to reach in clinical practice than in clinical trialsIt may take several weeks to months to achieve an individualized maintenance doseMaintenance doses in patients weighing less than 30 kgregardless of age or concomitant AEDmay need to be increased as much as 50based on clinical response.
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