LAMOTRIGINE AND VALPROATE
The serum levels of lamotrigine can be increased by sodium valproate. Small increases, decreases or no changes in sodium valproate levels have been seen with lamotrigine. Concurrent use has been associated with skin rashes and other toxic reactions.
Monitor the outcome of concurrent use. In patients already taking valproate, the manufacturer of lamotrigine recommends a lamotrigine starting dose that is half that of lamotrigine monotherapy, irrespective of whether they are also receiving enzyme-inducing antiepileptics, and a very gradual dose-escalation rate. The development of rashes should be investigated promptly.
Monitor the outcome of concurrent use. In patients already taking valproate, the manufacturer of lamotrigine recommends a lamotrigine starting dose that is half that of lamotrigine monotherapy, irrespective of whether they are also receiving enzyme-inducing antiepileptics, and a very gradual dose-escalation rate. The development of rashes should be investigated promptly.