Lamotrigine-associated rash: risk/benefit considerations in adults and children

Epilepsia
A H GubermanE Trevathan

Abstract

Lamotrigine (LTG) is an antiepileptic drug (AED) recently released in several countries. It is effective for a variety of seizure types in adults and children both as an add-on agent and in monotherapy, and is generally well tolerated. This report reviews the apparent risk factors for rash associated with LTG to determine whether and how the risk of serious rash can be minimized in practice. The panel of experts reviewed all published and unpublished data related to the incidence and risk factors for serious rash with LTG. An allergic skin reaction occurs in approximately 10% of patients, usually in the first 8 weeks. Rashes leading to hospitalization, including Stevens-Johnson syndrome and hypersensitivity syndrome, occurred in approximately one of 300 adults and one of 100 children in clinical trials and appeared to be increased with overrapid titration when starting therapy and with concurrent valproate (VPA). Recommendations are made for both minimizing the likelihood of serious rash and for management of rash in patients taking LTG. Risk of serious rash may possibly be lessened by strict adherence to manufacturer's dosing guidelines, particularly in patients who are at higher risk: those on concurrent VPA and in the pediat...Continue Reading

References

May 1, 1992·British Journal of Clinical Pharmacology·A W YuenA W Peck
Feb 1, 1992·Journal of Neurology·R J ElbleC Higgins
Jan 1, 1992·Epilepsia·V J Anttila, M Valtonen
Jan 1, 1991·Epilepsia·F Cirignotta, E Lugaresi
May 1, 1986·Epilepsia·C D BinnieA van Wieringen
Jan 1, 1982·Progress in Neurobiology·A ChapmanJ C Vernieres
Dec 14, 1995·The New England Journal of Medicine·J C RoujeauF Locati
Mar 1, 1995·Seizure : the Journal of the British Epilepsy Association·S J TavernorS W Brown
Nov 10, 1994·The New England Journal of Medicine·J C Roujeau, R S Stern
Jan 1, 1994·Epilepsia·A Richens
Mar 1, 1994·Epilepsia·C P PanayiotopoulosA R Tahan
Jul 1, 1993·European Journal of Pediatrics·T KonishiT Okada
Dec 1, 1995·The Journal of Pediatrics·F M BesagG Hosking
Jul 1, 1995·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·P Wolkenstein, J Revuz
Jan 1, 1996·Neurology·J DooleyE Smith
Oct 12, 1996·Lancet·M WadeliusA Rane
Feb 1, 1997·Seizure : the Journal of the British Epilepsy Association·F M BesagE L Mullens
Feb 1, 1997·Seizure : the Journal of the British Epilepsy Association·K Fogh, J Mai
Jun 1, 1997·The Annals of Pharmacotherapy·J J Chaffin, S M Davis
Jan 1, 1997·Dermatology : International Journal for Clinical and Investigative Dermatology·B SachsH C Schuppe
May 5, 1998·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·J MessenheimerF Young
Aug 1, 1997·Epilepsia·F J MackayR D Mann

❮ Previous
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Citations

Nov 26, 2008·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Adeline Ngo Su-YinKent R Olson
Mar 2, 2011·European Journal of Clinical Pharmacology·Nahuel Pereira de SilvaPatricia Saidon
Mar 16, 2002·Current Allergy and Asthma Reports·Olga Bessmertny, Trinh Pham
Jan 3, 2007·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Steven C Schachter
Mar 24, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·Elizabeth J Donner, O Carter Snead
Jan 31, 2004·Epilepsy & Behavior : E&B·Edward FaughtGilda P Womble
Jul 18, 2003·Clinical Therapeutics·Michael J McLean, Barry E Gidal
Oct 6, 2000·Pediatric Neurology·T F BarronM L Price
Jul 25, 2003·Pediatric Neurology·Sigride Thomé-SouzaKette D Valente
Oct 24, 2001·Epilepsy Research·S Arroyo, A de la Morena
Nov 26, 2002·Epilepsy Research·Emilio Perucca
Sep 6, 2003·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·Joseph R CalabreseMelvin D Shelton
Apr 12, 2003·Epilepsia·David V LardizabalMaria Del Mar Carreño
Feb 24, 2009·Journal of Child and Adolescent Psychopharmacology·Mani N PavuluriJohn A Sweeney
Aug 20, 2011·Journal of Child and Adolescent Psychopharmacology·Daniel J Safer
Jul 20, 2007·Toxicological Sciences : an Official Journal of the Society of Toxicology·Parvaneh EspandiariJoseph Hanig
Sep 16, 2003·The Neurologist·Suzette M LaRoche, Sandra L Helmers
May 24, 2007·International Clinical Psychopharmacology·Yu-Chih ShenChia-Hsiang Chen
Apr 11, 2000·Epilepsia·J A Messenheimer, A H Guberman
Jul 8, 2000·Epilepsia·R S Greenwood
Feb 28, 2006·Epilepsia·Lawrence J HirschStanley R Resor
Feb 27, 2007·Epilepsia·Graeme Sills, Martin Brodie
May 9, 2007·Epilepsia·Silje AlvestadEylert Brodtkorb
Feb 22, 2008·Epilepsia·Emilio Perucca
Apr 30, 2003·Pharmacogenomics·J Steven Leeder
Jan 1, 2010·Drug, Healthcare and Patient Safety·Jeffery W Britton, Jerry J Shih
Oct 25, 2012·Neuropsychiatric Disease and Treatment·Frank Mc Besag, Philip N Patsalos
Jun 19, 2009·Therapeutics and Clinical Risk Management·Russell P Saneto, Gail D Anderson
Oct 17, 2006·Drugs·Patrick Kwan, Martin J Brodie
Jun 8, 2001·Paediatric Drugs·C P Panayiotopoulos
Mar 3, 2010·CNS Drugs·Dean P Sarco, Blaise F D Bourgeois
Dec 3, 2010·Pharmacogenomics·Mara L Becker, J Steven Leeder
Dec 3, 2014·The Psychiatric Clinics of North America·Edgardo Rodriguez-Vallecillo, Michel A Woodbury-Fariña
Dec 11, 2014·European Journal of Drug Metabolism and Pharmacokinetics·Arne ReimersEylert Brodtkorb
Aug 16, 2001·Brain & Development·S J Wallace
Nov 19, 2003·Psychopharmacology Bulletin·Michael J Owens, Charles B Nemeroff
Sep 15, 2000·Current Opinion in Neurology·E Ben-Menachem

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