Abstracts

Rash related to lamotrigene use continues to concern prescribers. We reviewed our consecutive patient use of lamotrigene for rash frequencies to assess the risk.
We reviewed the complete use of lamotrigene from clinic records at the Regional Epilepsy Center. The exposures ae for patients seen from November of 2001 till April of 2003. Their demographic information including age, gender, seizure, lamotrigene titration rate, and epilepsy type were collected. The result of exposure to lamotrigene was recorded.
79 patients were exposed to lamotrigene. 17 had generalized epilepsy and the rest had localization-related epilepsy. Eight were co-medicated with valproate. There were 29 males and 50 females. 74 used the manufacturer[apos]s fixed titration package based on whether they were using valproate or enzyme-inducing co-medications. Two patients reported rashes. Neither was on valproate and both were taking enzyme-inducing agents. Both had used the fixed titration sample package provided by the manufacturer. Both patients were rechallenged using the titration package designed for valproate co-medicated patients without rash reoccurrance.
We conclude that lamotrigene exposure is not associated with a significant risk for rash and re-exposure at slower titration rates are possible without rash reoccurrance. We believe that appropriate titration is facilitated by the manufacturer[apos]s packaging and use that packaging for the re-exposure of patients using the valproate co-medicated form to accomplish this task.