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Some estrogen-containing oral contraceptives have been shown to decrease serum concentrations of lamotriginesee CLINICAL PHARMACOLOGYDosage adjustments will be necessary in most patients who start or stop estrogen-containing oral contraceptives while taking LAMICTALsee DOSAGE AND ADMINISTRATIONDuring the week of inactive hormone preparationpill-free weekof oral contraceptive therapyplasma lamotrigine levels are expected to riseas much as doubling at the end of the weekAdverse reactions consistent with elevated levels of lamotriginesuch as dizzinessataxiaand diplopiacould occur.

Lamictal may cause a severe or life-threatening skin rashespecially in children and in people who take too high a dose at the start of treatmentSerious skin rash may also be more likely to occur if you are taking lamotrigine together with valproic acidDepakeneor divalproexDepakote

If other drugs are subsequently introducedthe dose of LAMICTAL may need to be adjustedIn particularthe introduction of valproate requires reduction in the dose of LAMICTALsee DRUG INTERACTIONSCLINICAL PHARMACOLOGY

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