Lamictal Use In Pregnancy & Lactation

Fertility: Administration of lamotrigine did not impair fertility in animal reproductive studies.
There is no experience of the effect of Lamictal on human fertility.
Pregnancy: Post-marketing data from several prospective pregnancy registries have documented outcomes in over 8,700 women exposed to Lamictal monotherapy during the first trimester of pregnancy. Overall, these data do not suggest a substantial increase in the risk for major congenital malformations. Although data from a limited number of registries have reported an increase in the risk of isolated oral cleft malformations, a completed case control study did not demonstrate anincreased risk of oral clefts compared to other major congenital malformations following exposure to lamotrigine (see Non-Clinical Information under Actions).
The data on use of Lamictal in polytherapy combinations are insufficient to assess whether the risk of malformation associated with other agents is affected by concomitant Lamictal use.
As with other medicines, Lamictal should only be used during pregnancy if the expected benefits outweigh the potential risks.
Physiological changes during pregnancy may affect lamotrigine levels and/or therapeutic effect. There have been reports of decreased lamotrigine levels during pregnancy. Appropriate clinical management of pregnant women during Lamictal therapy should be ensured.
Lactation: Lamotrigine has been reported to pass into breast milk in highly variable concentrations, resulting in total lamotrigine levels in infants of up to approximately 50% of the mother’s. Therefore, in some breast-fed infants, serum concentrations of lamotrigine may reach levels at which pharmacological effects occur.
The potential benefits of breastfeeding should be weighed against the potential risk of adverse effects occurring in the infant.