英文药名：Lamictal（Lamotrigine）

中文药名：利必通（拉莫三嗪片）

药品说明
Lamotrigine为一治疗癫痫症药物、它的药理作用在於抑制脑部传导物质glutamate的释放以及抑制脑神经细胞不正常的放电。此药几乎对所有型态癫痫均有效、它可以单独使用或与其它癫痫药物一起并用以治疗多种类型的癫痫症如强直阵挛性发作癫痫、局部发作癫痫及严重LENNOX-GASTAUT SYNDROME癫痫徵候群之治疗等。Lamotrigine另一作用是可用於躁郁症的维持用药、通常与情绪稳定剂一起合用以延迟忧郁期再复发的时间。

分类名称
一级分类：神经系统药物 二级分类：抗癫痫药物 三级分类：其他 

药品英文名
Lamotrigine
 
药品别名
利必通、拉米克妥、那蒙特金、BW-430C、Lamictal、Lamotriginum
 
药物剂型
片剂：25mg，100mg，150mg，200mg。
 
药理作用
拉莫三嗪为苯基三嗪类化合物，属电压门控钠通道阻滞剂。通过减少钠内流来增加神经元的稳定性。在体外培养神经元中，本药可抑制戊四氮和电刺激所致的惊厥，缩短病灶、皮质和海马区兴奋后的放电时间，对抗部分和全身性癫痫发作。其作用机制可能是抑制脑内谷氨酸和天门冬氨酸诱发的暴发性放电；阻滞癫痫灶快速放电和神经元除极，但不影响正常神经兴奋传导。动物实验表明，本药抗惊厥作用与苯妥英钠、卡马西平等阻滞电惊厥和戊四氮导致的抽搐相似。
 
药动学
本药口服后迅速完全吸收。生物利用度可达98%。健康人和癫痫患者单剂量服用后，达峰浓度时间为0.5～5.0h，平均2.0～3.0h。本药血浆蛋白结合率为55%，表观分布容积为0.9～1.3L/kg。本药半衰期为6.4～30.4h，平均12.6h。若在服用丙戊酸钠基础上加服本药，半衰期可延长至11.2～51.6h，平均27h。本药主要在肝脏内通过与葡萄糖醛酸结合而代谢，代谢产物没有生物活性。通过肾脏排泄，其中10%为药物原形，2%通过粪便排泄。
 
适应证
1.成人或儿童癫痫复杂部分性发作的辅助治疗或单独治疗。
2.其他抗癫痫药不能控制的部分性和全身性癫痫发作的辅助治疗。
3.Lennox-Gastaut综合征的癫痫发作。
 
禁忌证
对本药过敏者。
 
注意事项
1.慎用：心、肝、肾功能受损者。
2.妊娠早期不宜使用。
 
不良反应
1.常见头痛、眩晕、嗜睡、共济失调、恶心、呕吐、视物模糊、复视和皮疹等，发生率与剂量相关。过量可出现嗜睡、头痛、甚至昏迷。
2.偶见变态反应、面部皮肤水肿、肢体坏死、腹胀、胃纳减退、体重减轻、光敏性皮炎和自杀倾向等。
3.罕见严重的皮疹、血管神经性水肿。有发生Stevens-Johnson综合征和中毒性表皮坏死溶解(Lyell综合征)的报道。
 
用法用量
口服给药：
1.在服用丙戊酸钠的患者中加用本药，前2周，每次用25mg，隔日1次；随后2周开始，每天服用25mg，此后每1～2周增加25～50mg，直至达到维持量每天100～150mg，分次口服。
2.不与丙戊酸钠合用者，每天从50mg开始，2周后改为每天100mg，分次服用，逐步加到维持量每天100～200mg，分次口服。
 
药物相应作用
1.在服用苯妥英钠和卡马西平的患者中加服本药，它们的相互作用不明显，互不影响稳态血药浓度；在服用本药的基础上加服苯妥英钠和卡马西平，将苯妥英钠和卡马西平的稳态血药浓度分别降低45%～54%和40%。
2.服用丙戊酸钠的患者加服本药后，可引起丙戊酸钠浓度降低；在服用本药的基础上加服丙戊酸钠则使本药的稳态浓度增加约40%。
3.对乙酰氨基酚可加速本药的排泄。
4.甲琥胺、奥卡西平、利托那韦可增加本药的代谢，减少其血浆浓度，甚至丧失抗癫痫作用。
5.舍曲林可抑制本药的代谢，使之毒性增强、引起疲乏、镇静、意识混乱等。
6.与食物同服可避免引起胃部刺激。
7.不必对本药进行常规的血药浓度监测，但在开始治疗时应严密监测血液中其他抗惊厥药的浓度。
8.对于需要停止本药治疗的患者，应在至少2周左右内减量，每周减量约50%(除非出于患者安全的考虑而需快速停药)。
9.下列因素可增加患者发生严重的、危及生命的皮疹的危险性：
(1)年龄小于16岁；
(2)与丙戊酸和已知可导致皮疹的抗生素合用；
(3)过量；
(4)本药的加量速度过快；
(5)伴有病毒性感染。—旦出现应立即停止治疗。
 
专家点评
当与其他抗癫痫药同用时，突然停用本药可引起癫痫反弹发作。除非出于安全性的考虑(例如皮疹)要求突然停药，否则本药的剂量应该在2周内逐渐减少至停药。当欲停止使用其他合用的抗癫痫药物以便达到本药单药治疗，或在本药单药治疗中添加其他抗癫痫药物时，都应考虑对拉莫三嗪药动学的影响。
LAMICTAL(lamotrigine) Tablets
LAMICTAL(lamotrigine) Chewable Dispersible Tablets
LAMICTAL ODT(lamotrigine) Orally Disintegrating Tablets
What is Lamictal?
Lamictal is an anti-epileptic medication, also called an anticonvulsant.
Lamictal is used alone or in combination with other medications to treat seizures in adults and children who are at least 2 years old. It is also used to delay mood episodes in adults with bipolar disorder.
Lamictal may also be used for other purposes not listed in this medication guide.
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Important information about Lamictal
Lamictal may cause severe or life-threatening skin rash, especially in children and in people who are allergic to other seizure medications. Serious skin rash may also be more likely to occur if you are taking Lamictal together with valproic acid (Depakene) or divalproex (Depakote). Seek emergency medical attention if you have a fever, sore throat, swollen glands, and headache with a severe blistering, peeling, and red skin rash.
If you have to stop taking Lamictal because of a serious skin rash, you may not be able to take it again in the future.
You may have thoughts about suicide while taking Lamictal.
Your doctor will need to check you at regular visits. Do not miss any scheduled
appointments.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Do not stop taking this medication without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking Lamictal suddenly. You will need
to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking Lamictal.
Taking this medication during early pregnancy can increase the risk of the baby being born with cleft lip or cleft palate.
Tell your doctor if you are pregnant or if you become pregnant during treatment.
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Before taking Lamictal
You should not use Lamictal if you are allergic to lamotrigine.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely use Lamictal:
kidney disease;
liver disease; or
heart disease.
You may have thoughts about suicide while taking Lamictal.
Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduledappointments.
FDA pregnancy category C. Lamictal may be harmful to an unborn baby.
Taking this medication during early pregnancy can increase the risk of the baby being born with cleft lip or cleft palate. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
Your name may need to be listed on a Lamictal pregnancy registry when you start using this medication.
Lamotrigine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
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How should I take Lamictal?
Take Lamictal exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
The extended-release form of lamotrigine (Lamictal XR) may be used for different conditions than immediate-release lamotrigine is used for. Always check your refills to make sure you have received the correct brand and type of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.
Your doctor may occasionally change your dose over several weeks or months to make sure you get the best results from this medication.
To make sure you are taking the right dose of this medication, your blood may need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.
If you are switching to Lamictal from another anticonvulsant medication, carefully follow your doctor's instructions about timing and dosage when switching from one drug to another.
Lamictal can be taken with or without food.
Take the regular Lamictal tablet with a full glass of water.
To take the chewable dispersible tablet, you may either swallow it whole with a glass of water, or chew it first and then swallow it. You may also place the tablet into 1 teaspoon
of water or diluted fruit juice and allow it to disperse in the liquid for about 1 minute. Gently swirl the liquid and then swallow all of the mixture right away. Do not save it for
later use.
Do not stop taking Lamictal without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking Lamictal suddenly. You will need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking this medication. Carry an ID card or wear a medical alert bracelet stating that you are taking Lamictal, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.
Birth control pills can make Lamictal less effective, which may result in increased seizures. Your Lamictal dose may need to be changed when you start or stop using birth control pills. You may also have side effects during the weeks when you are taking an inactive (placebo) pill from your birth control pack.
Tell your doctor if you plan to stop taking birth control pills.
It is important to use this medication regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Store this medication at room temperature away from light and moisture.
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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take
extra medicine to make up the missed dose.
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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include blurred vision, problems with coordination, increased seizures, feeling light-headed, or fainting.
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What should I avoid while taking Lamictal?
Lamictal can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
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Lamictal side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Lamictal: hives; fever; swollen glands; painful sores in or around your eyes or mouth;
difficulty breathing; swelling of your face, lips, tongue, or throat.
This medication may cause severe or life-threatening skin rash, especially in children and in people who are allergic to other seizure medications. Serious skin rash may also be more
likely to occur if you are taking Lamictal together with valproic acid (Depakene) or divalproex (Depakote). Seek emergency medical attention if you have a fever, sore throat,
swollen glands, and headache with a severe blistering, peeling, and red skin rash.
If you have to stop taking Lamictal because of a serious skin rash, you may not be able to take it again in the future.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have any of these serious side effects:
the first sign of any skin rash;
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
chest pain;
pale skin, easy bruising or bleeding;
fever, chills, body aches, flu symptoms;
muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious Lamictal side effects may include:
dizziness or drowsiness;
blurred vision;
mild nausea, vomiting, diarrhea, upset stomach;
headache;
lack of coordination;
weight loss;
sleep problems (insomnia), unusual dreams; orrunny or stuffy nose.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
You may report side effects to FDA at 1-800-FDA-1088.
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What other drugs will affect Lamictal?
Birth control pills can make Lamictal less effective, resulting in increased seizures. Tell your doctor if you start or stop using birth control pills while you are taking this medicine. Your dose may need to be changed.Before taking Lamictal, tell your doctor if you are using any of the following drugs:
hormonal forms of birth control (pills, injections, implants, or skin patches);
carbamazepine (Carbatrol, Tegretol);
divalproex (Depakote);
oxcarbazepine (Trileptal);
phenobarbital (Luminal, Solfoton);
primidone (Mysoline);
phenytoin (Dilantin);
rifampin (Rifadin, Rifater, Rifamate, Rimactane); orvalproic acid (Depakene).
This list is not complete and there may be other drugs that can interact with Lamictal. Tell your doctor about all the prescription and over-the-counter medications you use.
This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
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Where can I get more information?
Your pharmacist can provide more information about Lamictal.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs,
diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients
and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient.
Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to
cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
附件：

20096801021216.pdf
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注：以下产品不同规格和不同价格，购买时请以电话咨询为准！
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原产地英文商品名:
LAMICTAL TABLET 25mg/Tablet 30Tablets/box
原产地英文药品名:
LAMOTRIGINE
中文参考商品译名:
利必通片剂 25毫克/片 30片/盒
中文参考药品译名:
拉莫三嗪
生产厂家中文参考译名:
史克必成
生产厂家英文名:
SMITHKLINE BEECHAM

---------------------------------------------------------------
原产地英文商品名:
LAMICTAL TABLET 100mg/Tablet 30Tablets/box
原产地英文药品名:
LAMOTRIGINE
中文参考商品译名:
利必通片剂 100毫克/片 30片/盒
中文参考药品译名:
拉莫三嗪
生产厂家中文参考译名:
史克必成
生产厂家英文名:
SMITHKLINE BEECHAM

---------------------------------------------------------------
原产地英文商品名:
LAMICTAL TABLET 150mg/Tablet 30Tablets/box
原产地英文药品名:
LAMOTRIGINE
中文参考商品译名:
利必通片剂 150毫克/片 30片/盒
中文参考药品译名:
拉莫三嗪
生产厂家中文参考译名:
史克必成
生产厂家英文名:
SMITHKLINE BEECHAM

---------------------------------------------------------------
原产地英文商品名:
LAMICTAL TABLET 200mg/Tablet 30Tablets/box
原产地英文药品名:
LAMOTRIGINE
中文参考商品译名:
利必通片剂 200毫克/片 30片/盒
中文参考药品译名:
拉莫三嗪
生产厂家中文参考译名:
史克必成
生产厂家英文名:
SMITHKLINE BEECHAM