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    Lamitrin

    Lamotrigine
    Dispersible Tablet 5 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamitrin

    Lamotrigine
    Tablet 50 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamitrin

    Lamotrigine
    Tablet 25 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamitrin

    Lamotrigine
    Dispersible Tablet 2 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamitrin ER

    Lamotrigine
    Tablet (Extended Release) 100 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamivir

    Lamivudine [For Chronic Hepatitis B]
    Tablet 100 mg Allopathic Hepatic viral infections (Hepatitis B)

    Indications

    Hepatitis B virus

    Indication detailsView
    Lamivudine is indicated for the treatment of chronic hepatitis B associated with evidence of hepatitis B viral replication and active liver inflammation.
    Therapeutic classView
    Hepatic viral infections (Hepatitis B)
    PharmacologyView
    Lamivudine is a synthetic nucleoside analogue. Lamivudine is phosphorylated intracellularly to lamivudine triphosphate. Incorporation of the monophosphate form into viral DNA occurs by hepatitis B virus (HBV) polymerase. As a result DNA chain is terminated. Lamivudine triphosphate also inhibits the RNA and DNA-dependent DNA polymerase activities of HIV-1 reverse transcriptase (RT). Lamivudine triphosphate is a very weak inhibitor of mammalian alpha, beta, and gamma-DNA polymerases.
    DosageView
    The recommended oral dose of Lamivudine for the treatment of chronic hepatitis B in adults is 100 mg once daily.
    Side effectsView
    Several serious adverse events reported with lamivudine (lactic acidosis and severe hepatomegaly with steatosis, post treatment exacerbations of hepatitis B, pancreatitis, and emergence of viral mutants associated with reduced drug susceptibility and diminished treatment response). Malaise, fatigue, fever, ENT infections, sore throat, nausea, vomiting, abdominal discomfort, pain, diarrhea, myalgia, arthralgia, headache, skin rashes may occur. Lactic acidosis and severe hepatomegaly with steatosis, have been reported.
    ContraindicationsView
    Lamivudine is contraindicated in patients hypersensitive to any of the components of the product.
    PrecautionsView
    Patients should be assessed before beginning treatment and during treatment with lamivudine by a physician experienced in the management of chronic hepatitis B.
    InteractionsView
    Trimethoprim 160 mg / Sulfamethoxazole 800 mg once daily has been shown to increase lamivudine exposure (AUC). The effect of higher doses of trimethoprim /sulfamethoxazole on lamivudine pharmacokinetics has not been investigated.
    Pregnancy & lactationView
    There is no adequate and well-controlled study in pregnant women. Lamivudine should be used during pregnancy only if the potential benefits outweigh the risks. Although it is not known if lamivudine is excreted in human milk, there is the potential for adverse effects from lamivudine in nursing infants. Mothers should be instructed not to breast feed if they are receiving lamivudine.
    Pediatric usageView
    It is recommended that doses of Lamivudine should be adjusted in accordance with renal function. Dosage adjustment of Lamivudine in accordance with creatinine clearance is as follows:
    • CrCl 50 ml/min: 100 mg once daily
    • CrCl 30-49 ml/min: 100 mg first dose, then 50 mg once daily
    • CrCl 15-29 ml/min: 100 mg first dose, then 25 mg once daily
    • CrCl 5-14 ml/min: 35 mg first dose, then 15 mg once daily
    • CrCl <5 ml/min: 35 mg first dose, then 10 mg once daily
    Use in children: Safety and efficacy of lamivudine for the treatment of chronic hepatitis B in children have not been established.
    StorageView
    Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.

    Lamogin

    Lamotrigine
    Dispersible Tablet 2 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamogin

    Lamotrigine
    Dispersible Tablet 5 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamogin

    Lamotrigine
    Tablet 25 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lamogin

    Lamotrigine
    Tablet 50 mg Allopathic Primary anti-epileptic drugs

    Indications

    Unipolar and bipolar depression

    Indication detailsView
    Lamotrigine is indicated for:

    Epilepsy-combination therapy in patients aged 2 years and older:
    • partial-onset seizures
    • primary generalized tonic-clonic seizures
    • generalized seizures of Lennox-Gastaut syndrome
    Epilepsy-monotherapy in patients aged 16 years and older.

    Adults with Bipolar Disorder.
    Therapeutic classView
    Primary anti-epileptic drugs
    PharmacologyView
    The exact mechanism of action of lamotrigine is not fully elucidated, as it may exert cellular activities that contribute to its efficacy in a range of conditions. Although chemically unrelated, lamotrigine actions resemble those of phenytoin and carbamazepine, inhibiting voltage-sensitive sodium channels, stabilizing neuronal membranes, thereby modulating the release of presynaptic excitatory neurotransmitters.

    Lamotrigine likely acts by inhibiting sodium currents by selective binding to the inactive sodium channel, suppressing the release of the excitatory amino acid, glutamate. The mechanism of action of lamotrigine in reducing anticonvulsant activity is likely the same in managing bipolar disorder. Studies on lamotrigine have identified its binding to sodium channels in a fashion similar to local anesthetics, which could explain the demonstrated clinical benefit of lamotrigine in some neuropathic pain states.

    Lamotrigine displays binding properties to several different receptors. In laboratory binding assays, it demonstrates weak inhibitory effect on the serotonin 5-HT3 receptor. Lamotrigine also weakly binds to Adenosine A1/A2 receptors, α1/α2/β adrenergic receptors, dopamine D1/D2 receptors, GABA A/B receptors, histamine H1 receptors, κ-opioid receptor (KOR), mACh receptors and serotonin 5-HT2 receptors with an IC50>100 µM. Weak inhibitory effects were observed at sigma opioid receptors. An in vivo study revealed evidence that lamotrigine inhibits Cav2.3 (R-type) calcium currents, which may also contribute to its anticonvulsant effects.
    DosageView

    Epilepsy-
    Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
    • In patients taking Valproate: 25 mg every day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
    • In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
    • In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)
    Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)
    Weeks 3 & 4:
    In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)
    • In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)
    Week 5 onward to maintenance:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
    • In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day
    Usual maintenance dose:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
    • In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)
    Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

    Weeks 1 & 2:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
    • If the patients weight is 14.1 kg to 27 kg: 2 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 4 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 5 mg every day
    Weeks 3 & 4:
    • If the patients weight is 6.7 kg to 14 kg: 2 mg every day
    • If the patients weight is 14.1 kg to 27 kg: 4 mg every day
    • If the patients weight is 27.1 kg to 34 kg: 8 mg every day
    • If the patients weight is 34.1 kg to 40 kg: 10 mg every day
    Bipolar disorder-

    Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
    Weeks 1 & 2:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
    • In patients taking Valproate: 25 mg every other day
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily
    Weeks 3 & 4:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
    • In patients taking Valproate: 25 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)
    Week 5:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
    • In patients taking Valproate: 50 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)
    Week 6:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)
    Week 7:
    • In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
    • In patients taking Valproate: 100 mg daily
    • In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)
    Side effectsView
    Common side effects of Lamotrigine include-dizziness, tremor, headache, rash, blurred vision, fever, lack of coordination, abdominal pain, infections, sleepiness, back pain, vomiting, diarrhea, tiredness, insomnia, dry mouth, stuffy nose, sore throat.
    PrecautionsView
    Serious skin rashes, Blood Dyscrasias, Suicidal Behavior, Aseptic Meningitis can occur in both adult and pediatric population.
    InteractionsView
    Lamotrigine interacts with Oral contraceptives, Atazanavir/ritonavir, Carbamazepine, Levetiracetam, Lithium, Lopinavir/ritonavir , Olanzapine, Phenobarbital/primidone , Phenytoin, Pregabalin etc.
    Pregnancy & lactationView
    Pregnancy Category C. Lamotrigine is excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from Lamotrigine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
    Pediatric usageView
    Pediatric Use:
    • Epilepsy: Safety and effectiveness of Lamotrigine used as adjunctive treatment for partial onset seizures were not demonstrated in very young pediatric patient's aged 1 to 24 months.
    • Bipolar Disorder: Safety and effectiveness of Lamotrigine for the maintenance treatment of bipolar disorder were not established in pediatric patient's aged 10 to 17 years.
    Overdose effectsView
    Overdose has resulted in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased level of consciousness, coma, and intraventricular conduction delay.
    StorageView
    Store below 30°C. Protect from light and moisture. Keep out of the reach of children.

    Lanfos

    Lanthanum Carbonate
    Chewable Tablet 250 mg Allopathic Drugs used in chronic kidney dialysis

    Indications

    End-stage renal failure

    Indication detailsView
    Lanthanum Carbonate is a phosphate binder indicated to reduce serum phosphate in patients with end-stage renal disease (ESRD).
    Therapeutic classView
    Drugs used in chronic kidney dialysis
    PharmacologyView
    Lanthanum Carbonate is a phosphate binder that reduces absorption of phosphate by forming insoluble Lanthanum phosphate complexes that pass through the Gl tract unabsorbed. Both serum phosphate and calcium phosphate product are reduced as a consequence of the reduced dietary phosphate absorption.

    In vitro studies have shown that Lanthanum binds phosphate in the physiologically relevant pH range of 3 to 7. In simulated gastric fluid, Lanthanum binds approximately 97% of the available phosphate at pH 3-5 and 67% at pH 7, when Lanthanum is present in a two-fold molar excess to phosphate. Bile acids have not been shown to affect the phosphate binding affinity of Lanthanum. In order to bind dietary phosphate, Lanthanum Carbonate must be administered with or immediately after meals.
    DosageView
    The recommended initial total daily dose of Lanthanum Carbonate is 1,500 mg in divided doses. Titrate every 2 to 3 weeks based on serum phosphate level. Take Lanthanum Carbonate with or immediately after meals.

    Lanthanum Carbonate Chewable Tablets: Do not swallow tablets whole. Chew or crush tablet completely before swallowing.
    Side effectsView
    The most common adverse reactions for Lanthanum Carbonate were gastrointestinal events, such as nausea, vomiting, and abdominal pain and they generally abated over time with continued dosing. The following adverse reactions have been identified during post-approval use of Lanthanum Carbonate constipation, dyspepsia, allergic skin reactions, and tooth injury while chewing the tablet.
    ContraindicationsView
    Contraindicated in bowel obstruction, including ileus and fecal impaction.
    PrecautionsView
    Gastrointestinal Adverse Effects: Serious cases of gastrointestinal obstruction, ileus, subileus, gastrointestinal perforation, and fecal impaction have been reported in patients taking Lanthanum, some requiring surgery or hospitalization. During treatment with Lanthanum Carbonate, physicians and patients should remain vigilant for signs and symptoms of gastrointestinal disorders, especially constipation and abdominal pain/distention, which may indicate bowel obstruction, ileus, or subileus. Treatment with Lanthanum Carbonate should be re-evaluated in patients who develop severe constipation or other severe gastrointestinal signs and symptoms. Advise patients who are prescribed Lanthanum Carbonate Chewable Tablets to chew the tablet completely and not to swallow them whole. Serious gastrointestinal complications have been reported in association with unchewed or incompletely chewed tablets.
    InteractionsView
    Drugs Binding to Antacids: There is a potential for Lanthanum Carbonate to interact with compounds which bind to cationic antacids (i.e., aluminum-,magnesium-, or calcium-based); therefore, do not administer such compounds within 2 hours of dosing with Lanthanum Carbonate.

    Quinolone Antibiotics: Co-administration of Lanthanum Carbonate with quinolone antibiotics may reduce the extent of their absorption. The bioavailability of oral ciprofloxacin was decreased by approximately 50% when taken with Lanthanum Carbonate in a single-dose study in healthy volunteers. Administer oral quinolone antibiotics at least 1 hour before or 4 hours after Lanthanum Carbonate. When oral quinolones are given for short courses, consider eliminating the doses of Lanthanum Carbonate that would normally be scheduled near the time of quinolone intake to improve quinolone absorption.

    Levothyroxine: the bioavailability of levothyroxine was decreased by approximately 40% when taken together with Lanthanum Carbonate. Administer thyroid hormone replacement therapy at least 2 hours before or 2 hours after dosing with Lanthanum Carbonate and monitor thyroid stimulating hormone (TSH).
    Pregnancy & lactationView
    Pregnancy: Available data from case reports with use of Lanthanum Carbonate in pregnant women are insufficient to identify a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Use a non-Lanthanum containing phosphate binder in a pregnant woman.

    Lactation: There are no data on the presence of Lanthanum Carbonate from Lanthanum Carbonate in human milk, the effects on the breastfed infant, or the effects on milk production. Use a non-Lanthanum containing phosphate binder in a lactating woman.
    Pediatric usageView
    Pediatric Use: The safety and efficacy of Lanthanum Carbonate in pediatric patients have not been established. The use of Lanthanum Carbonate in this population is not recommended.

    Geriatric Use: Of the total number of patients in clinical studies of Lanthanum Carbonate, 32% (538) were >65 years of age, while 9.3% (159) were >75 years of age. No overall differences in safety or effectiveness were observed between patients >65 years of age and younger patients.
    Overdose effectsView
    The symptoms associated with overdose are adverse reactions such as headache, nausea and vomiting. In clinical trials in healthy adults, gastrointestinal (Gl) symptoms were reported with daily doses up to 6,000 mg/day of Lanthanum Carbonate administered with food.
    StorageView
    Store in a cool (below 30° C) and dry place, away from light. Keep out of the reach of children.

    Lanib

    Lenvatinib Mesylate
    Capsule 4 mg Allopathic
    Indication detailsView
    Lenvatinib is a kinase inhibitor that is indicated:
    • Differentiated Thyroid Cancer: Lenvatinib is indicated for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC).
    • Renal Cell Carcinoma: Lenvatinib is indicated in combination with Everolimus for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior anti-angiogenic therapy.
    • Hepatocellular Carcinoma: Lenvatinib is indicated for the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC).
    • Endometrial Carcinoma: Lenvatinib, in combination with Pembrolizumab, is indicated for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy and are not candidates for curative surgery or radiation.
    PharmacologyView
    Lenvatinib is a kinase inhibitor that inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4). Lenvatinib inhibits other kinases that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors FGFR1, 2, 3, and 4; platelet-derived growth factor receptor alpha (PDGFR ), KIT, and RET. Lenvatinib also exhibited antiproliferative activity in hepatocellular carcinoma cell lines dependent on activated FGFR signaling with concurrent inhibition of FGF-receptor substrate 2 (FRS2 ) phosphorylation.

    Absorption: The time to peak plasma concentration (Tmax) typically occurred from 1 to 4 hours post-dose. Administration with a high-fat meal (approximately 900 calories of which approximately 55% were from fat, 15% from protein, and 30% from carbohydrates) did not affect the extent of absorption, but decreased the rate of absorption and delayed the median Tmax from 2 hours to 4 hours.

    Distribution: In vitro binding of Lenvatinib to human plasma proteins ranged from 98% to 99% at concentrations of 0.3 to 30 μg/mL. The blood-to-plasma concentration ratio ranged from 0.59 to 0.61 at concentrations of 0.1 to 10 μg/mL in vitro.

    Metabolism: The main metabolic pathways for Lenvatinib in humans were identified as enzymatic (CYP3A and aldehyde oxidase) and non-enzymatic processes. Excretion: Ten days after a single administration of radiolabeled Lenvatinib, approximately 64% and 25% of the radiolabel were eliminated in the feces and urine, respectively.

    Elimination: The terminal elimination half-life of Lenvatinib was approximately 28 hours.
    DosageView
    Important Dosage Information: The dose reduction is needed for certain patients with renal or hepatic impairment. Lenvatinib should be taken once daily, with or without food, at the same time each day. If a dose is missed and cannot be taken within 12 hours, skip that dose and take the next dose at the usual time of administration.

    Recommended Dosage for Differentiated Thyroid Cancer (DTC): The recommended dosage of Lenvatinib is 24 mg orally once daily until disease progression or until unacceptable toxicity.

    Recommended Dosage for Renal Cell Carcinoma (RCC): The recommended dosage of Lenvatinib is 18 mg in combination with 5 mg Everolimus orally once daily until disease progression or until unacceptable toxicity.

    Recommended Dosage for Hepatocellular Carcinoma (HCC): The recommended dosage of Lenvatinib is based on actual body weight: 12 mg for patients greater than or equal to 60 kg or 8 mg for patients less than 60 kg. Lenvatinib should be taken orally once daily until disease progression or until unacceptable toxicity.

    Recommended Dosage for Endometrial Carcinoma: The recommended dosage of Lenvatinib is 20 mg orally once daily, in combination with Pembrolizumab 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks, until unacceptable toxicity or disease progression.
    AdministrationView
    Lenvatinib capsules can be swallowed whole or dissolved in a small glass of liquid. To dissolve in liquid, put capsules into 1 tablespoon of water or apple juice without breaking or crushing the capsules. Leave the capsules in the water or apple juice for at least 10 minutes. Stir for at least 3 minutes. After drinking the mixture, add 1 tablespoon of water or apple juice to the glass, swirl the contents a few times and swallow the water or apple juice.
    Side effectsView
    Hypertension, cardiac dysfunction, arterial thromboembolic events, hepatotoxicity, renal failure and impairment, proteinuria, diarrhea, fistula formation and gastrointestinal perforation, QT Interval Prolongation, hypocalcemia, reversible posterior leukoencephalopathy syndrome, hemorrhagic events, impairment of thyroid stimulating hormone suppression/thyroid dysfunction, wound healing complications.
    ContraindicationsView
    It is contraindicated in patients with known hypersensitivity to Lenvatinib or to any component of the formulation.
    PrecautionsView
    Hypertension: Control blood pressure prior to initiating Lenvatinib. Monitor blood pressure after 1 week, then every 2 weeks for the first 2 months, and then at least monthly thereafter during treatment. Withhold and resume at a reduced dose when hypertension is controlled or permanently discontinue Lenvatinib is based on severity.

    Cardiac Dysfunction: Serious and fatal cardiac dysfunction can occur with Lenvatinib. Monitor patients for clinical symptoms or signs of cardiac dysfunction. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.

    Arterial Thromboembolic Events: Permanently discontinue Lenvatinib following an arterial thrombotic event. The safety of resuming Lenvatinib after an arterial thromboembolic event has not been established and Lenvatinib has not been studied in patients who have had an arterial thromboembolic event within the previous 6 months.

    Hepatotoxicity: Monitor liver function prior to initiating Lenvatinib, then every 2 weeks for the first 2 months, and at least monthly thereafter during treatment. Monitor patients with HCC closely for signs of hepatic failure, including hepatic encephalopathy. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.

    Renal Failure or Impairment: Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib for renal failure or impairment based on severity.

    Proteinuria: Monitor for proteinuria prior to initiating Lenvatinib and periodically during treatment. If urine dipstick proteinuria greater than or equal to 2+ is detected, obtain a 24-hour urine protein. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.

    Diarrhea: Diarrhea was the most frequent cause of dose interruption/reduction and diarrhea recurred despite dose reduction. Promptly initiate management of diarrhea. Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib based on severity.

    Fistula Formation and Gastrointestinal Perforation: Permanently discontinue Lenvatinib in patients who develop gastrointestinal perforation of any severity or Grade 3 or 4 fistula.

    QT Interval Prolongation: Monitor and correct electrolyte abnormalities at baseline and periodically during treatment. Monitor electrocardiograms in patients with congenital long QT syndrome, congestive heart failure, bradyarrhythmias, or those who are taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. Withhold and resume at a reduced dose of Lenvatinib upon recovery based on severity.

    Hypocalcemia: Hypocalcemia improved or resolved following calcium supplementation, with or without dose interruption or dose reduction.

    Reversible Posterior Leukoencephalopathy Syndrome: Withhold and resume at a reduced dose upon recovery or permanently discontinue Lenvatinib depending on severity and persistence of neurologic symptoms.

    Hemorrhagic Events: Consider the risk of severe or fatal hemorrhage associated with tumor invasion or infiltration of major blood vessels (e.g. carotid artery). Withhold and resume at reduced dose upon recovery or permanently discontinue Lenvatinib based on the severity.

    Impairment of Thyroid Stimulating Hormone Suppression/Thyroid Dysfunction: Monitor thyroid function prior to initiating Lenvatinib and at least monthly during treatment. Treat hypothyroidism according to standard medical practice.

    Wound Healing Complications: Wound healing complications, including fistula formation and wound dehiscence, can occur with Lenvatinib. Withhold Lenvatinib for at least 6 days prior to scheduled surgery. Resume Lenvatinib after surgery based on clinical judgment of adequate wound healing. Permanently discontinue Lenvatinib in patients with wound healing complications.
    InteractionsView
    Drugs That Prolong the QT Interval: Lenvatinib has been reported to prolong the QT/QTc interval. Avoid coadministration of Lenvatinib with medicinal products with a known potential to prolong the QT/QTc interval.
    Pregnancy & lactationView
    Use in Pregnancy: Based on the mechanism of action, Lenvatinib can cause embryo-fetal harm when administered to a pregnant female. Pregnant women should be advised of the potential risk to a fetus. Females of reproductive potential should be advised to use effective contraception during treatment with Lenvatinib and for at least 30 days after the last dose.

    Use in Lactation: It is not known whether Lenvatinib is present in human milk. Because of the potential for serious adverse reactions in breastfed infants, women should be advised to discontinue breastfeeding during treatment with Lenvatinib and for at least 1 week after the last dose.
    Pediatric usageView
    Dosage Modifications for Severe Renal Impairment: The recommended dosage of Lenvatinib for patients with DTC, RCC, or endometrial carcinoma and severe renal impairment (creatinine clearance less than 30 mL/min calculated by Cockcroft-Gault equation using actual body weight) is:
    • Differentiated thyroid cancer: 14 mg orally once daily
    • Renal cell carcinoma: 10 mg orally once daily
    • Endometrial carcinoma: 10 mg orally once daily
    Dosage Modifications for Severe Hepatic Impairment: The recommended dosage of Lenvatinib for patients with DTC, RCC, or endometrial carcinoma and severe hepatic impairment (Child-Pugh C) is:
    • Differentiated thyroid cancer: 14 mg taken orally once daily
    • Renal cell carcinoma: 10 mg taken orally once daily
    • Endometrial carcinoma: 10 mg orally once daily Or as directed by the registered physician.
    Pediatric Use: The safety and effectiveness in pediatric patients have not been established.
    Overdose effectsView
    Due to the high plasma protein binding, Lenvatinib is not expected to be dialyzable. Death due to multiorgan dysfunction occurred in a patient who received a single dose of Lenvatinib 120 mg orally.
    StorageView
    Store below 30°C in a dry place. Protect from light. Keep out of the reach of children.

    Lanoxin

    Digoxin
    Tablet 0.25 mg Allopathic Positive Inotropic drugs

    Indications

    Supraventricular arrhythmias

    Indication detailsView
    Digoxin is indicated in:
    • Heart failure.
    • Atrial fibrillation with an uncontrolled ventricular rate.
    • Acute left ventricular failure.
    • Chronic left ventricular failure and conjestive heart failure,especially when caused by hypertensive valvular (especially mitral valvular) disease or ischaemic heart disease.
    Therapeutic classView
    Positive Inotropic drugs
    PharmacologyView
    Digoxin is a cardiac glycoside used in the management of particularly atrial fibrillation and in heart failure.The principal actions of digoxin are an increase in the force of myocardial contraction (positive inotropic activity and a reduction in the conductivity of the heart particularly in conduction through the atrioventricular node. Digoxin also has a direct action on vascular smooth muscle and indirect effects mediated primarily by the autonomic nervous system and particularly by an increase in vagal activity.
    DosageView
    By oral administration:
    • Rapid digitalization: 1-1.5 mg in divided doses over 24 hours
    • Less urgent digitalization: 250-500 micrograms daily (higher dose may be divided)
    • Maintenance: 62.5-500 micrograms daily (higher dose may be divided) according to renal function and in atrial fibrillation on heart rate response.
    • Usual range: 125-250 micrograms daily (lower dose may be divided) according to renal function and in atrial fibrilation on heart rate response.
    • Usual range: 125-250 micrograms daily (lower dose may be appropriate in the elderly).
    Side effectsView
    Usually associated with excessive dosage include anorexia, nausea, vomiting, diarrhoea, abdominal pain, visual disturbance, headache, fatigue, drowsiness, confusion, delirium, hallucination, depression, arrhythmia, heart block, intestinal ischaemia, gynaecomastia on long term use, thrombocytopenia reported. Digoxin can be safely used in pregnancy
    ContraindicationsView
    • Ventricular fibrillation.
    • Hypersensitivity to digoxin or other digitalis preparation.
    InteractionsView
    Potassium-depleting diuretics increase the effects of digitalis. Calcium particularly if administered rapidly by the intravenous route, may produce serious arrhythmia in digitalized patients. Quinidine, verapamil, amiodarone, propafenone, indomethacin, itraconazole, alprazolam, spironolactone, erythromycin, clarithromycin (and possibly other macrolide antibiotics) and tetracycline increase digoxin serum level. Besides antacids, kaolinpectin, sulfasalazine, neomycin, penicillamine, calestipol, metoclopramide, rifampin may interfere with intestinal absorption of digoxin resulting low serum concentrations of the drug.
    Pregnancy & lactationView
    Digoxin is excreted in breast milk but in concentration below those found in plasma and therefore poses no hazard to the breast-fed infant.
    Pediatric usageView
    Neonates: Digoxin can be used in neonates.

    Children: Digoxin can be used in children.

    The elderly: Partly because of reduced renal function and partly because their tissues are more sensitive to the effects of digitalis, the elderly require a lower maintenance dose of digoxin than younger adults.
    StorageView
    Store in a cool and dry place.Keep out of the reach of children.

    Lanozole

    Lansoprazole
    Capsule (Delayed Release) 30 mg Allopathic Proton Pump Inhibitor

    Indications

    Peptic ulcer disease

    Indication detailsView
    Lansoprazole is indicated for:
    • Short term treatment of active duodenal ulcer
    • Maintenance of healed duodenal ulcers
    • Short term treatment of active benign gastric ulcers
    • Short term treatment of active erosive esophagitis
    • Maintenance of healing of erosive esophagitis
    • Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
    • H. pylori eradication to reduce the risk of duodenal ulcer recurrence
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.
    DosageView
    Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.

    Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.

    NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.

    Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.

    Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.

    Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
    Side effectsView
    Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.

    Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
    ContraindicationsView
    Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
    InteractionsView
    Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
    Pregnancy & lactationView
    Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
    Pediatric usageView
    Neonates:There is no relevant human data. The drug is not recommended for use with neonates.

    Children: The youngest person to have received Lansoprazole in clinical trials was 13 years old.

    The Elderly: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.
    StorageView
    Store at 25° C.

    Lanozole

    Lansoprazole
    Capsule (Delayed Release) 15 mg Allopathic Proton Pump Inhibitor

    Indications

    Peptic ulcer disease

    Indication detailsView
    Lansoprazole is indicated for:
    • Short term treatment of active duodenal ulcer
    • Maintenance of healed duodenal ulcers
    • Short term treatment of active benign gastric ulcers
    • Short term treatment of active erosive esophagitis
    • Maintenance of healing of erosive esophagitis
    • Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
    • H. pylori eradication to reduce the risk of duodenal ulcer recurrence
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.
    DosageView
    Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.

    Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.

    NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.

    Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.

    Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.

    Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
    Side effectsView
    Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.

    Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
    ContraindicationsView
    Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
    InteractionsView
    Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
    Pregnancy & lactationView
    Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
    Pediatric usageView
    Neonates:There is no relevant human data. The drug is not recommended for use with neonates.

    Children: The youngest person to have received Lansoprazole in clinical trials was 13 years old.

    The Elderly: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.
    StorageView
    Store at 25° C.

    Lanplus

    Dexlansoprazole
    Capsule (Delayed Release) 30 mg Allopathic Proton Pump Inhibitor

    Indications

    Oesophagitis

    Indication detailsView
    Healing of Erosive Esophagitis: Dexlansoprazole is indicated for the healing of all grades of erosive esophagitis (EE) for up to 8 weeks.

    Maintenance of Healed Erosive Esophagitis: Dexlansoprazole is indicated to maintain healing of EE and relief of heartburn for up to 6 months.

    Symptomatic Non-Erosive Gastroesophageal Reflux Disease: Dexlansoprazole is indicated for the treatment of heartburn associated with symptomatic non-erosive Gastroesophageal Reflux Disease (GERD) for 4 weeks.
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Dexlansoprazole delayed-release capsule is a Proton Pump Inhibitor (PPI) which suppresses gastric acid secretion by specific inhibition of the (H+/K+)-ATPase in the gastric parietal cell. By acting specifically on the proton pump, Dexlansoprazole blocks the final step of acid production. It is the R-enantiomer of lansoprazole (A racemic mixture of the R- and S-enantiomers). Dexlansoprazole is supplied as a Dual Delayed Release (DDR) formulation in a capsule for oral administration. This capsule contains a mixture of two types of enteric coated granules with different pH-dependent dissolution profiles. The dual delayed release formulation in dexlansoprazole, plasma concentration-time profile with two distinct peaks; the first peak occurs 1 to 2 hours after administration, followed by a second peak within 4 to 5 hours. After oral administration, mean Cmax and AUC value of Dexlansoprazole increased approximately dose proportionally. Dexlansoprazole is extensively metabolized in the liver and excreated by urine.
    DosageView
    Dexlansoprazole dosing recommendations-
    • Maintenance of Healed erosive esophagitis and relief of heartburn: 30 mg Once daily
    • Symptomatic Non-Erosive GERD: 30 mg Once daily for 4 weeks
    • Healing of erosive esophagitis: 60 mg Once daily for up to 8 weeks
    AdministrationView
    Dexlansoprazole can be taken without regard to food. It should be swallowed whole.

    Alternatively, Dexlansoprazole capsules can be administered as follows:
    • Open capsule
    • Sprinkle intact granules on one tablespoon
    • Swallow immediately.
    Granules should not be chewed.

    If a capsule is missed at its usual time, it should be taken as soon as possible. But if it is too close to the time of the next dose, only the prescribed dose should be taken at the appointed time. A double dose should not be taken.
    Side effectsView
    Common side effects: Diarrhea, abdominal pain, nausea, vomiting & flatulence.
    ContraindicationsView
    Dexlansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric Malignancy, Clostridium difficile Associated Diarrhea, Bone fracture, Hypomagnesemia, and concomitant use of Dexlansoprazole with Methotrexate.
    InteractionsView
    With medicine: Atazanavir, Warfarin, Tacrolimus, Clopidogrel & Methotrexate. With food & others: No data available.
    Pregnancy & lactationView
    Pregnancy Category B. There is no adequate and well-controlled studies with Dexlansoprazole in pregnant women. There is no adequate and well-controlled studies with Dexlansoprazole in Lactating mother.
    Pediatric usageView
    Use in children & adolescents: Safety and effectiveness of Dexlansoprazole in patients below 12 years age have not been established.

    Geriatric use: No dose adjustment is necessary for elderly patients.

    Renal impairment: No dose adjustment of Dexlansoprazole is necessary for patients with renal
    impairment.

    Hepatic impairment: No dose adjustment for Dexlansoprazole is necessary for patients with mild hepatic impairment. A maximum daily dose of Dexlansoprazole 30 mg should be considered for patients with moderate hepatic impairment.
    Overdose effectsView
    There have been no reports of a significant overdose of Dexlansoprazole. Multiple doses of Dexlansoprazole 120 mg and a single dose of Dexlansoprazole 300 mg did not result in death or other severe adverse events.
    StorageView
    Store below 30°C temperature & in a dry place, protected from light. Keep all medicines out of reach of children.

    Lanplus

    Dexlansoprazole
    Capsule (Delayed Release) 60 mg Allopathic Proton Pump Inhibitor

    Indications

    Oesophagitis

    Indication detailsView
    Healing of Erosive Esophagitis: Dexlansoprazole is indicated for the healing of all grades of erosive esophagitis (EE) for up to 8 weeks.

    Maintenance of Healed Erosive Esophagitis: Dexlansoprazole is indicated to maintain healing of EE and relief of heartburn for up to 6 months.

    Symptomatic Non-Erosive Gastroesophageal Reflux Disease: Dexlansoprazole is indicated for the treatment of heartburn associated with symptomatic non-erosive Gastroesophageal Reflux Disease (GERD) for 4 weeks.
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Dexlansoprazole delayed-release capsule is a Proton Pump Inhibitor (PPI) which suppresses gastric acid secretion by specific inhibition of the (H+/K+)-ATPase in the gastric parietal cell. By acting specifically on the proton pump, Dexlansoprazole blocks the final step of acid production. It is the R-enantiomer of lansoprazole (A racemic mixture of the R- and S-enantiomers). Dexlansoprazole is supplied as a Dual Delayed Release (DDR) formulation in a capsule for oral administration. This capsule contains a mixture of two types of enteric coated granules with different pH-dependent dissolution profiles. The dual delayed release formulation in dexlansoprazole, plasma concentration-time profile with two distinct peaks; the first peak occurs 1 to 2 hours after administration, followed by a second peak within 4 to 5 hours. After oral administration, mean Cmax and AUC value of Dexlansoprazole increased approximately dose proportionally. Dexlansoprazole is extensively metabolized in the liver and excreated by urine.
    DosageView
    Dexlansoprazole dosing recommendations-
    • Maintenance of Healed erosive esophagitis and relief of heartburn: 30 mg Once daily
    • Symptomatic Non-Erosive GERD: 30 mg Once daily for 4 weeks
    • Healing of erosive esophagitis: 60 mg Once daily for up to 8 weeks
    AdministrationView
    Dexlansoprazole can be taken without regard to food. It should be swallowed whole.

    Alternatively, Dexlansoprazole capsules can be administered as follows:
    • Open capsule
    • Sprinkle intact granules on one tablespoon
    • Swallow immediately.
    Granules should not be chewed.

    If a capsule is missed at its usual time, it should be taken as soon as possible. But if it is too close to the time of the next dose, only the prescribed dose should be taken at the appointed time. A double dose should not be taken.
    Side effectsView
    Common side effects: Diarrhea, abdominal pain, nausea, vomiting & flatulence.
    ContraindicationsView
    Dexlansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric Malignancy, Clostridium difficile Associated Diarrhea, Bone fracture, Hypomagnesemia, and concomitant use of Dexlansoprazole with Methotrexate.
    InteractionsView
    With medicine: Atazanavir, Warfarin, Tacrolimus, Clopidogrel & Methotrexate. With food & others: No data available.
    Pregnancy & lactationView
    Pregnancy Category B. There is no adequate and well-controlled studies with Dexlansoprazole in pregnant women. There is no adequate and well-controlled studies with Dexlansoprazole in Lactating mother.
    Pediatric usageView
    Use in children & adolescents: Safety and effectiveness of Dexlansoprazole in patients below 12 years age have not been established.

    Geriatric use: No dose adjustment is necessary for elderly patients.

    Renal impairment: No dose adjustment of Dexlansoprazole is necessary for patients with renal
    impairment.

    Hepatic impairment: No dose adjustment for Dexlansoprazole is necessary for patients with mild hepatic impairment. A maximum daily dose of Dexlansoprazole 30 mg should be considered for patients with moderate hepatic impairment.
    Overdose effectsView
    There have been no reports of a significant overdose of Dexlansoprazole. Multiple doses of Dexlansoprazole 120 mg and a single dose of Dexlansoprazole 300 mg did not result in death or other severe adverse events.
    StorageView
    Store below 30°C temperature & in a dry place, protected from light. Keep all medicines out of reach of children.

    Lansec

    Lansoprazole
    Capsule (Delayed Release) 30 mg Allopathic Proton Pump Inhibitor

    Indications

    Peptic ulcer disease

    Indication detailsView
    Lansoprazole is indicated for:
    • Short term treatment of active duodenal ulcer
    • Maintenance of healed duodenal ulcers
    • Short term treatment of active benign gastric ulcers
    • Short term treatment of active erosive esophagitis
    • Maintenance of healing of erosive esophagitis
    • Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
    • H. pylori eradication to reduce the risk of duodenal ulcer recurrence
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.
    DosageView
    Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.

    Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.

    NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.

    Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.

    Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.

    Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
    Side effectsView
    Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.

    Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
    ContraindicationsView
    Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
    InteractionsView
    Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
    Pregnancy & lactationView
    Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
    Pediatric usageView
    Neonates:There is no relevant human data. The drug is not recommended for use with neonates.

    Children: The youngest person to have received Lansoprazole in clinical trials was 13 years old.

    The Elderly: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.
    StorageView
    Store at 25° C.

    Lansec

    Lansoprazole
    Capsule (Delayed Release) 15 mg Allopathic Proton Pump Inhibitor

    Indications

    Peptic ulcer disease

    Indication detailsView
    Lansoprazole is indicated for:
    • Short term treatment of active duodenal ulcer
    • Maintenance of healed duodenal ulcers
    • Short term treatment of active benign gastric ulcers
    • Short term treatment of active erosive esophagitis
    • Maintenance of healing of erosive esophagitis
    • Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
    • H. pylori eradication to reduce the risk of duodenal ulcer recurrence
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.
    DosageView
    Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.

    Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.

    NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.

    Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.

    Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.

    Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
    Side effectsView
    Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.

    Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
    ContraindicationsView
    Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
    InteractionsView
    Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
    Pregnancy & lactationView
    Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
    Pediatric usageView
    Neonates:There is no relevant human data. The drug is not recommended for use with neonates.

    Children: The youngest person to have received Lansoprazole in clinical trials was 13 years old.

    The Elderly: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.
    StorageView
    Store at 25° C.

    Lansina

    Lansoprazole
    Capsule (Delayed Release) 30 mg Allopathic Proton Pump Inhibitor

    Indications

    Peptic ulcer disease

    Indication detailsView
    Lansoprazole is indicated for:
    • Short term treatment of active duodenal ulcer
    • Maintenance of healed duodenal ulcers
    • Short term treatment of active benign gastric ulcers
    • Short term treatment of active erosive esophagitis
    • Maintenance of healing of erosive esophagitis
    • Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
    • H. pylori eradication to reduce the risk of duodenal ulcer recurrence
    Therapeutic classView
    Proton Pump Inhibitor
    PharmacologyView
    Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.
    DosageView
    Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.

    Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.

    NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.

    Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.

    Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.

    Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
    Side effectsView
    Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.

    Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
    ContraindicationsView
    Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
    PrecautionsView
    Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
    InteractionsView
    Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
    Pregnancy & lactationView
    Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
    Pediatric usageView
    Neonates:There is no relevant human data. The drug is not recommended for use with neonates.

    Children: The youngest person to have received Lansoprazole in clinical trials was 13 years old.

    The Elderly: No problems have been encoun- tered in clinical use and there has been no increase in adverse drug reaction in the elderly.
    StorageView
    Store at 25° C.