What should I do if I develop a rash while taking lamotrigine?

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Official answer

by Drugs.com

Contact your healthcare provider or other emergency medical services right away if you develop a rash or other signs of a drug allergy (such as a fever or swelling of your lymph nodes) while taking lamotrigine. This could signal you are having a serious side effect to lamotrigine which may result in hospitalization or cause death.

Call your healthcare provider right away if you have any of the following:

  • a skin rash
  • blistering or peeling of your skin
  • hives
  • painful sores in your mouth or around your eyes
  • These symptoms may be the first signs of a serious skin reaction.

    Your healthcare provider should examine you to decide if you should continue taking lamotrigine. Do not stop lamotrigine or change your dose without first talking to a healthcare provider. Stopping treatment quickly may lead to serious problems, like seizures.

    There is no way to know if the skin rash will become more serious, even if it seems mild at first. Not all rashes that occur with lamotrigine are serious, but your healthcare provider should make that decision.

    Lamotrigine (brand name: Lamictal) is classified as an anticonvulsant and is approved by the FDA:

  • to treat certain seizures in children and adults
  • to delay mood episodes in adults with bipolar disorder (also known as manic depression).
  • What increases my risk for a rash with lamotrigine?

    A serious skin rash can happen at any time during your treatment with lamotrigine, but is more likely to happen within the first 2 to 8 weeks of treatment. Children and teenagers 2 to 17 years of age have a higher chance of getting a serious skin rash with lamotrigine.

    The risk of getting a serious, life-threatening skin rash may also be higher if you:

  • take lamotrigine while taking valproate [Depakene (valproic acid) or Depakote (divalproex sodium)].
  • take a higher starting dose of lamotrigine than your healthcare provider prescribed.
  • increase your dose of lamotrigine faster than prescribed.
  • However, these factors have not yet been proven and cases have occurred in the absence of these factors.

    Review: Lamotrigine Warnings and Side Effects

    Before you start treatment with lamotrigine, tell your doctor If you have had a rash or allergic reaction to another antiseizure (epilepsy) medicine in the past.

    Lamotrigine can also cause other types of allergic reactions or serious side effects that may affect your organs and other parts of your body like your liver or blood cells. You may or may not have a rash with these types of reactions.

    Discuss all possible, life-threatening side effects with your health care provider before treatment. Learn how to recognize these side effects and what you should do if they should occur. Do not take lamotrigine if you are allergic to it or any inactive ingredients in the product.

    Is a rash with lamotrigine common?

    Benign (non-serious) rashes are also caused by lamotrigine. Rashes are listed as a common side effect (occurring greater than 5% to 10% of the time) in the product labeling. But it is not possible to predict which rashes will become serious or life threatening and which will be benign.

    Lamotrigine carries a Boxed Warning for serious skin rashes which outlines the frequency. A Boxed Warning is the FDA’s most prominent drug safety warning.

    In the Boxed Warning, it notes that serious rashes, which have included Stevens-Johnson syndrome, have occurred in less than 1% of patients receiving lamotrigine (about 0.3% to 0.8% of children aged 2 to 17 years and 0.08% to 0.3% in adults).

    Rash-related deaths and toxic epidermal necrolysis have been rarely reported, but their numbers are too few to permit a precise estimate of the rate.

  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • This is not all the information you need to know about lamotrigine for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

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