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Prior to initiation of treatment with LAMICTALthe patient should be instructed that a rash or other signs or symptoms of hypersensitivitye.gfeverlymphadenopathymay herald a serious medical event and that the patient should report any such occurrence to a physician immediately.

It is important to note that early manifestations of hypersensitivitye.gfeverlymphadenopathymay be present even though a rash is not evidentIf such signs or symptoms are presentthe patient should be evaluated immediatelyLAMICTAL should be discontinued if an alternative etiology for the signs or symptoms cannot be established.

Lamictal is approved by the FDA for the maintenance treatment of adults with bipolar disorderIt has been found to help delay bouts of depressionmaniahypomaniaa milder form of maniaand mixed episodes in those being treated with standard therapyIt is especially effective in the prevention of bipolar depressionIt was the first FDA-approved therapy since lithium for maintenance in bipolar disorder.

Gradual transient increasesinlamotrigine plasmalevels(approximate 2-fold increase)occurred duringtheweek of inactivehormone preparationpill-freeweekfor womennotalso takinga drug that increased the clearance of lamotriginecarbamazepinephenytoinphenobarbitalprimidoneor other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce lamotrigine glucuronidationsee DRUG INTERACTIONSThe increase in lamotrigine plasma levels will be greater if the dose of LAMICTAL is increased in the few days before or during the pill-free weekIncreases in lamotrigine plasma levels could result in dose-dependent adverse reactions.

The net effects of drug interactions with lamotrigine are summarized in Tables 13 and 15followed by details of the drug interaction studies below.

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read the entire fda prescribing information for lamictal lamotrigine .