question about new med change

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Hey long time no see everyone!

So went to see the shrink and to keep me on some meds that will work on my seizures but also on my bi-polar she is taking me off my topamax and putting me on lamotrigine.
And my question is do I take this in the Am or at night?
I'll be starting the pill 1 daily for a week 2 tabs at the 2nd week 3 tabs the third week and then 4 tabs the 4th week, would I take them all at once? or break them up over the whole day? My shrink didn't tell me any complete instructions I called and left a please call message but last time i did that it took over a week before I got a call back.
SO anybody who has taken this please let me know.
I have read about the rash and don't want to mistake this med since I read taking it wrong at the start can cause it to happen faster. Thanks in advance to all the brains out in the land. Happy halloween in advance!

Thornton8000
 
Everyone is different with regards to their response to meds and have different needs with the individual meds (as in your case, seizure control plus tx for bipolar). I honestly don't think it would be appropriate for anyone here to tell you when to take your medications. You could start with the pharmacist, though, regarding general dosing recommendations for those in your situation - after all, they are experts on medication - until you wait to hear from the prescribing doctor.
 
thornton8000

I am incline to agree with Masterjen, as you know we all react differently but I would not start them until I heard back and was told when to take them. However having said that - and this applies only to me - when I started lamotrigine I had to start in the morning and as it built up I split the doses, now this is how I was told. But I know another man who started in the evening. The rash started for me after 2 weeks but it was gone by the end of the next 2 weeks. I find it increases your apatite a lot (now I need to lose weight) so you might want to watch that, other wise no problem for me.
 
Fedup,

So with the rash di you keep taking the med while the rash was still there?
I was told if the rash showed up stop and don't keep taking them, if it makes you hungry I'll just need to find some better snacks since I need to lose weight already! (that will be my catch 22 lol)

masterjen,

I can understand what you are saying in regards to my dx's i have been stable for the most part and dealing with a whole other can of worms lately which is why this med change is happening so since I've gotten great advice on my meds and support in the past I've felt safe in sharing here. And since they are taking one of my regular meds away and changing it for a new one I needed some help again and just wanted everyone's help again!

And hope to hear about everyone's experience about this med as well

Thornton8000
 
Is it regular lamotrigine, or the extended release form? I'm currently on 600 mg of the XR, so I split it up 300 in the AM and 300 in the PM. When I was on the regular form, I personally took it in the morning.

As for my experience with it, I've been on it since I was diagnosed 12 years ago and haven't had any issues at all when it comes to side effects.
 
Hi. I've been on it for maybe 20 years now. I know that you have to be careful and increase the dose very slowly, so follow your docs instructions on that. As for the dosing schedule, the literature and the pdr and the docs pretty much say twice a day dosing. In my case I was never able to get above 500 mg per day (250 AM and 250 PM) without side-effects, and I still didn't have good seizure control. Other meds I tried in that time were completely intolerable and didn't work either. About six months ago I found out, through talking to my pharmacist and looking at a detailed printout of my seizure frequency that I would probably be better off taking it four times a day.(Both my pharmacist and the doctor said that there was nothing wrong with 4x/day dosing). When I started that I was able to get up to 650 a day with no side-effects, and I have not had a seizure for 5 months now. That's by far the longest I have gone since I was diagnosed in 1982. When I asked my epileptologist why I had never seen anything about QID dosing, and why no one had ever suggested it to me, she said that most people would have problems taking something four times a day. I thought that was an absolutely insane thing to say since I'm sure most people could figure out how to do that.
I won't get on a soapbox here about this any more, but if you find that things aren't going well re: control vs. side-effects that might be the answer for you, too.
 
I don't know how long I've been on lamictal, I don't take XR. I take 325 in the am and in the pm. I'm sure the dr started me out at a low dosage and worked me up to the current dosage that I'm on now. He had also told me to take the 325 in the am and 325 in the pm, splitting it up and not taking it all at once.

Asking a pharmacist really wouldn't help in my opinion. They will probably tell you that it is usually taken in a certain way but that doesn't mean that it is how your dr wants you to take it.

If you take the full dosage all at once at the same time could cause an overdose. But who knows that too might be how your dr wants you to take it? They could want you to split it up taking so much once, twice, three times or more - who knows?

I agree with the others. Don't start taking it until you find out exactly how your dr wants you to take it.
 
Huh. I have never thought about taking my meds in different doses other than the typical morning/evenings. I take lamotrigine too along with carbamazepine, it's 3 pills each, 1 and a half twice daily. These 2 seem to be working, I do have seizure's still, but definitely not as many as I've had with many other meds I've been on.
I think the next appointment I have I'll talk to the dr. about just taking the 3 pills 3 times a day instead. I hope he'll agree and maybe I can get a better control over the seizures!
 
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I take regular (nonXR) lamotrigine. 100mg around 8 a.m. and 75mg in the evening around 6pm. As noted above, your doc should give you proper guidance on the dosing. When you speak to him, you might want to ask about slowing down the rate of increase (spending more time at each dose plateau). Going "low and slow" can help reduce the risk of allergic rash (distinct from the SJS rash), and potentially help to minimize side effects.
 
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