Lamictal

Renal impairment

Only about 10% of lamotrigine is cleared by the kidney. Nevertheless, the elimination half-life of lamotrigine is increased by approximately 50% in patients with renal insufficiency. 54 The dose of lamotrigine may need to be reduced in these patients.54,55

Hemodialysis

Lamotrigine is poorly soluble in water, is approximately 50% bound to plasma proteins, and has a modest volume of distribution. In a study of 6 subjects on hemodialysis, an average of 20% (range 5.6% to 35.1%) of lamotrigine present in the body was eliminated during a 4-hour hemodialysis session.54

Adapted from: Browne TR. Renal disorders. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;49-62.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised February 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.