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Bipolar I disorder
Adult: As immediate-release: Monotherapy or adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, increased to 50 mg daily for 2 weeks, then 100 mg daily for 1 week, then to 200 mg daily (usual target dose). Daily doses from week 3 may be given as a single or in 2 divided doses. Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, increased to 25 mg once daily for 2 weeks, then 50 mg daily for 1 week, then to 100 mg daily (usual target dose). Max: 200 mg daily. Daily doses from week 5 may be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, increased to 50 mg bid for 2 weeks, then 100 mg bid for 1 week, then 150 mg bid for 1 week. If needed, may increase to 200 mg bid (usual target dose). Increase doses based on response and tolerability. Dosage adjustments may be required if other drugs are added to or withdrawn from therapy (refer to detailed product guideline).
Oral
Generalised tonic-clonic seizures
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. Adjunctive therapy with valproate (regardless of any concomitant medications): Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid for 2 weeks, then increase by Max of 100 mg every 1-2 weeks. Usual maintenance: 200-400 mg daily in 2 divided doses, may increase up to 700 mg daily if necessary. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Increase doses based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate (regardless of any concomitant drugs): Initially, 0.15 mg/kg once daily for 2 weeks, then 0.3 mg/kg once daily for 2 weeks, then increase by Max of 0.3 mg/kg every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily as a single or in 2 divided doses. Max: 200 mg daily. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg every 1-2 weeks. Usual maintenance: 1-10 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate (regardless of any concomitant drugs): Initially, 0.15 mg/kg once daily for 2 weeks, then 0.3 mg/kg once daily for 2 weeks, then increase by Max of 0.3 mg/kg every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily as a single or in 2 divided doses. Max: 200 mg daily. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg every 1-2 weeks. Usual maintenance: 1-10 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Oral
Partial seizures
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. As immediate/extended-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks. Doses may then be increased by Max of 25-50 mg daily every 1-2 weeks (immediate-release); or increased to 50 mg once daily at week 5, 100 mg once daily at week 6, and 150 mg once daily at week 7 (extended-release). Usual maintenance: 100-200 mg daily as a single or in 2 divided doses (immediate-release); 200-250 mg once daily (extended-release). Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid (immediate-release) or 100 mg once daily (extended-release) for 2 weeks. Doses may then be increased by Max of 100 mg daily every 1-2 weeks (immediate-release) or weekly for the next 3 weeks (extended-release). Usual maintenance: 200-400 mg daily or 300-500 mg daily in 2 divided doses (immediate-release); 400-600 mg once daily (extended-release). If needed, may increase up to 700 mg daily (immediate-release). Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks. Doses may then be increased by Max of 50-100 mg daily every 1-2 weeks (immediate-release), or by 50 mg weekly for the next 3 weeks (extended-release). Usual maintenance: 100-200 mg daily as a single or in 2 divided doses or 225-375 mg daily in 2 divided doses (immediate-release); 300-400 mg once daily (extended-release). Increase doses based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years As immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years As immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Oral
Primary generalised tonic-clonic seizures
Adult: As extended-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks; increase to 50 mg once daily at week 5, 100 mg once daily at week 6, then 150 mg once daily at week 7. Usual maintenance: 200-250 mg once daily. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 100 mg once daily for 2 weeks; increase to 200 mg once daily at week 5, 300 mg once daily at week 6, then 400 mg once daily at week 7. Usual maintenance: 400-600 mg once daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks; increase to 100 mg once daily at week 5, then 150 mg once daily at week 6, then 200 mg once daily at week 7. Usual maintenance: 300-400 mg once daily. Alternative dosing for immediate-release: Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily (with valproate alone) or 100-400 mg daily (with valproate and other drugs that induce glucuronidation) as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg daily for 2 weeks, then 100 mg daily in 2 divided doses for 2 weeks, then increase by Max of 100 mg daily every 1-2 weeks. Usual maintenance: 300-500 mg daily in 2 divided doses. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg daily for 2 weeks, then increase by Max of 50 mg daily every 1-2 weeks. Usual maintenance: 225-375 mg daily in 2 divided doses. Increase dose based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years Alternative dosing for immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily, or 1-3 mg/kg daily (with valproate alone). Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily for 2 weeks, then 1.2 mg/kg daily for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily. Max: 400 mg daily. Doses to be given in 2 divided doses. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily as single or in 2 divided doses for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Usual maintenance: 4.5-7.5 mg/kg daily. Max: 300 mg daily. Doses from week 3 may be given in 2 divided doses. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years As immediate/extended-release: Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: 2-12 years Alternative dosing for immediate-release: Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily, or 1-3 mg/kg daily (with valproate alone). Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily for 2 weeks, then 1.2 mg/kg daily for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily. Max: 400 mg daily. Doses to be given in 2 divided doses. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily as single or in 2 divided doses for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Usual maintenance: 4.5-7.5 mg/kg daily. Max: 300 mg daily. Doses from week 3 may be given in 2 divided doses. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years As immediate/extended-release: Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Oral
Typical absence seizure
Child: 2-12 years As immediate-release: Monotherapy: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg every 1-2 weeks. Usual maintenance: 1-10 mg/kg daily, may increase up to 15 mg/kg daily if necessary. Doses to be given as a single or in 2 divided doses. Increase dose based on response and tolerability.
Oral
Seizures associated with the Lennox-Gastaut syndrome
Adult: As immediate-release: Monotherapy: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses, may increase up to 500 mg daily if necessary. Adjunctive therapy with valproate: Initially, 25 mg once every other day for 2 weeks, then 25 mg once daily for 2 weeks, then increase by Max of 25-50 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 50 mg once daily for 2 weeks, then 50 mg bid for 2 weeks, then increase by Max of 100 mg daily every 1-2 weeks. Usual maintenance: 200-400 mg daily or 300-500 mg daily in 2 divided doses. If needed, may increase up to 700 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 25 mg once daily for 2 weeks, then 50 mg once daily for 2 weeks, then increase by Max of 50-100 mg daily every 1-2 weeks. Usual maintenance: 100-200 mg daily as a single or in 2 divided doses or 225-375 mg daily in 2 divided doses. Increase dose based on response and tolerability. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
Child: As immediate-release: 2-12 years Adjunctive therapy with valproate: Initially, 0.15 mg/kg daily for 2 weeks, then 0.3 mg/kg daily for 2 weeks, then increase by Max of 0.3 mg/kg daily every 1-2 weeks. Usual maintenance: 1-5 mg/kg daily. Max: 200 mg daily. Doses to be given as a single or in 2 divided doses. Adjunctive therapy with inducers of lamotrigine glucuronidation without valproate: Initially, 0.6 mg/kg daily in 2 divided doses for 2 weeks, then 1.2 mg/kg daily in 2 divided doses for 2 weeks, then increase by Max of 1.2 mg/kg daily every 1-2 weeks. Usual maintenance: 5-15 mg/kg daily as a single or in 2 divided doses. Max: 400 mg daily. Adjunctive therapy without valproate and inducers of lamotrigine glucuronidation: Initially, 0.3 mg/kg daily for 2 weeks, then 0.6 mg/kg daily for 2 weeks, then increase by Max of 0.6 mg/kg daily every 1-2 weeks. Doses to be given as a single or in 2 divided doses. Usual maintenance: 1-10 mg/kg daily as a single or in 2 divided doses, or 4.5-7.5 mg/kg daily in 2 divided doses. Max: 200 mg or 300 mg daily. In patients weighing <30 kg: Dose increase by as much as 50% may be needed. Increase doses based on response and tolerability. Round dose down to the nearest whole tablet. >12 years Same as adult dose. Dosage recommendations may vary among countries and individual products (refer to detailed product guideline).
