folic acid<\/a><\/strong> if you are planning to become pregnant and while you are pregnant.<\/li><\/ul>\n\n\n\n\u2192\u00a0If you are breastfeeding or planning to breastfeed, ask your doctor or pharmacist for advice before taking this medicine.\u00a0<\/strong>The active substance in Lamotrigine Ratiopharm tablets is excreted in breast milk and may affect the baby.\u00a0Your doctor will discuss the risks and benefits of breastfeeding during treatment with lamotrigine.\u00a0If you choose to breastfeed, the doctor will check the baby from time to time to see if the baby is drowsy, rash, or has poor weight gain.\u00a0Tell your doctor if you notice any of these symptoms in your child.<\/p>\n\n\n\nDriving and using machines<\/h2>\n\n\n\n
Lamotrigine Ratiopharm may cause dizziness and double vision.<\/p>\n\n\n\n
\u2192 Do not drive or use machines unless you are feeling well.<\/strong><\/p>\n\n\n\nIf you have\u00a0epilepsy, talk to your doctor about driving and using machines.<\/strong><\/p>\n\n\n\nYou are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n
Lamotrigine ratiopharm contains sorbitol (E420) and sodium<\/h2>\n\n\n\n
Lamotrigine ratiopharm contains sorbitol (E420)<\/strong><\/p>\n\n\n\nSorbitol is a source of fructose.\u00a0If you (or your child) do not tolerate certain sugars, or if you (or your child) have been diagnosed with\u00a0hereditary\u00a0fructose intolerance, a rare, inherited disease that\u00a0prevents fructose\u00a0from being broken down, consult a doctor before using this medicine.<\/p>\n\n\n\n
Lamotrigine ratiopharm contains sodium<\/strong><\/p>\n\n\n\nThis medicine contains less than 1 mmol (23 mg)\u00a0sodium\u00a0per tablet, ie essentially ‘sodium-free.<\/p>\n\n\n\n
How to take Lamotrigine ratiopharm<\/h2>\n\n\n\n
Always take Lamotrigine Ratiopharm exactly as your doctor has told you.\u00a0<\/strong>Ask your doctor or pharmacist if you are unsure.<\/p>\n\n\n\nHow much Lamotrigine Ratiopharm to take<\/strong>
It may take a while to find the\u00a0dose\u00a0of Lamotrigine Ratiopharm that is best for you.\u00a0The dose\u00a0you take depends on:<\/p>\n\n\n\n- your age<\/li>
- whether or not you are taking Lamotrigine ratiopharm with other medicines<\/li>
- if you have kidney or liver problems.<\/li><\/ul>\n\n\n\n
Your doctor will start you on a low\u00a0dose\u00a0and increase the\u00a0dose\u00a0gradually over a few weeks until you reach a\u00a0dose\u00a0that works for you (called the\u00a0effective\u00a0dose of\u00a0one<\/em>\u00a0).\u00a0Never take Lamotrigine Ratiopharm more than your doctor has told you.<\/strong><\/p>\n\n\n\nThe usual effective\u00a0dose of\u00a0Lamotrigine Ratiopharm for adults and children from 13 years of age is between 100 mg and 400 mg daily.<\/p>\n\n\n\n
For children between 2 and 12 years of age, the effective dose depends on one’s body weight – usually between 1 mg and 15 mg for each kilogram of the child’s weight up to a maintenance dose of no more than 200 mg daily.<\/p>\n\n\n\n
Lamotrigine Ratiopharm is not recommended for children under 2 years of age.<\/p>\n\n\n\n
How to take your\u00a0dose of\u00a0Lamotrigine Ratiopharm<\/strong>
Take your\u00a0dose of\u00a0Lamotrigine Ratiopharm once or twice daily according to your doctor’s instructions.\u00a0You can take it with or without food.<\/p>\n\n\n\nYour doctor may also tell you to start or stop taking other medicines, depending on the condition you are being treated for and how you are reacting to the treatment.<\/p>\n\n\n\n
- Always take the full dose<\/strong> prescribed by your<\/strong> doctor. Never take just one part of a tablet.<\/li><\/ul>\n\n\n\n
Lamotrigine Ratiopharm dispersible tablets can be either swallowed whole with a little water or mixed with water for a liquid medicine:<\/p>\n\n\n\n
To make a liquid medicine:<\/strong><\/p>\n\n\n\n- Put the tablet in a glass with at least enough water to cover the whole tablet.<\/li>
- Stir to dissolve the tablet or wait about a minute until the tablet is completely dissolved.<\/li>
- Drink all the liquid.<\/li>
- Add a little more water to the glass and drink it, to be sure that no medicine is left in the glass.<\/li><\/ul>\n\n\n\n
If you take more Lamotrigine ratiopharm than you should<\/h2>\n\n\n\n
If you have ingested too much medicine or if e.g. a child ingested the medicine accidentally contact a doctor, hospital, or the Poison Information Center (tel. 112) for risk assessment and advice.<\/p>\n\n\n\n
If you take too much\u00a0Lamotrigine Ratiopharm, you are more\u00a0likely to\u00a0get serious\u00a0side effects\u00a0that can be life-threatening<\/strong>.\u00a0A person who has taken too much Lamotrigine Ratiopharm may experience any of these symptoms:<\/p>\n\n\n\n- rapid, uncontrolled eye movements ( nystagmus<\/em> )<\/li>
- clumsiness and lack of coordination ability that affects balance ( ataxia<\/em> )<\/li>
- changes in heart rate (usually detected on ECG )<\/li>
- loss of consciousness, seizures (convulsions) or coma .<\/li><\/ul>\n\n\n\n
If you forget to take a dose of Lamotrigine ratiopharm<\/h2>\n\n\n\n
\u2192\u00a0Do not take extra tablets to compensate for a missed\u00a0dose.\u00a0Just take your next\u00a0dose\u00a0at the usual time.<\/strong><\/p>\n\n\n\nIf you forget to take multiple\u00a0doses of\u00a0Lamotrigine Ratiopharm<\/strong><\/p>\n\n\n\n\u2192\u00a0Ask your doctor how to start taking the medicine again<\/strong>.\u00a0You must ask about this.<\/p>\n\n\n\nDo not stop taking Lamotrigine ratiopharm without consulting your doctor<\/h2>\n\n\n\n
Lamotrigine Ratiopharm should be taken for as long as your doctor recommends it.\u00a0Do not stop without your doctor telling you to.<\/p>\n\n\n\n
If you are taking Lamotrigine<\/strong> Ratiopharm for\u00a0epilepsy
To stop taking Lamotrigine Ratiopharm, your dose must be reduced gradually<\/strong>\u00a0over about 2 weeks.\u00a0If you suddenly stop taking Lamotrigine Ratiopharm, your\u00a0epilepsy\u00a0may come back or get worse.<\/p>\n\n\n\nIf you take Lamotrigine Ratiopharm for\u00a0bipolar disorder<\/strong>
It may take some time before Lamotrigine Ratiopharm works and therefore you will probably not feel better right away.\u00a0If you stop taking Lamotrigine Ratiopharm, your\u00a0dose\u00a0does not need to be reduced gradually.\u00a0However, you should still talk to your doctor first, if you want to stop taking Lamotrigine Ratiopharm.<\/p>\n\n\n\nPossible side effects<\/h2>\n\n\n\n
Like all medicines, this medicine can cause side effects, although not everybody gets them.<\/p>\n\n\n\n
Possible life-threatening reactions: contact a doctor immediately<\/strong><\/p>\n\n\n\nA small number of people taking Lamotrigine Ratiopharm have an\u00a0allergic reaction\u00a0or a skin reaction that can be life-threatening and develop into more serious problems if left untreated.<\/p>\n\n\n\n
It is most likely that you have these symptoms during the first few months of treatment with Lamotrigine Ratiopharm, especially if you start on too high a\u00a0dose\u00a0or\u00a0dose of\u00a0an increased too quickly, or if you are taking Lamotrigine Ratiopharm together with another medicine called\u00a0valproate.\u00a0Some symptoms are more common in children so parents should pay extra attention.<\/p>\n\n\n\n
Symptoms of such reactions include:<\/p>\n\n\n\n
- skin rash or redness<\/strong> , which can develop into a life-threatening skin reaction that includes widespread skin rash with blisters and flaky skin, especially around the mouth, nose, eyes and genitals ( Stevens-Johnson syndrome )<\/em> , extensive flaking of the skin (more than 30% of body surface area – toxic epidermal necrolysis )<\/em> or widespread skin rash affecting the liver, blood and other body organs (drug reaction with eosinophilia and systemic symptoms, also known as DRESS hypersensitivity syndrome).<\/li>
- sores in the mouth, throat, nose or genitals<\/strong><\/li>
- sore mouth or red and swollen eyes<\/strong> (eye inflammation)<\/li>
- fever<\/strong> , flu-like symptoms or drowsiness<\/li>
- swelling around the face<\/strong> or in the neck, armpits or groin<\/li>
- unexpected bleeding or bruising<\/strong> or that the fingers turn blue<\/li>
- sore throat<\/strong> or more infection (for example, colds) than usual<\/li>
- increased liver enzyme levels are seen in blood tests<\/li>
- increase in a type of white blood cell ( eosinophilia )<\/li>
- enlarged lymph nodes<\/li>
- effects on body organs including liver and kidneys.<\/li><\/ul>\n\n\n\n
In many cases, these symptoms are signs of less serious\u00a0side effects,\u00a0but you need to be\u00a0aware that they can be life-threatening and lead to more serious problems, such as organ failure if\u00a0left<\/strong>\u00a0untreated.\u00a0If you notice any of these symptoms:<\/p>\n\n\n\n\u2192 Contact a doctor immediately.\u00a0<\/strong>Your doctor may decide to take samples of your liver, kidneys, or blood and may tell you to stop taking Lamotrigine Ratiopharm.\u00a0If you have had\u00a0Stevens-Johnson syndrome\u00a0or\u00a0toxic epidermal necrolysis, your doctor will tell you never to use lamotrigine again.<\/p>\n\n\n\nHaemophagocytic syndrome (HLH)<\/strong>\u00a0(see section 2 What you need to know before you take Lamotrigine Ratiopharm).<\/p>\n\n\n\nVery common <\/strong>side effects are<\/strong><\/p>\n\n\n\nMay affect more than 1<\/strong> user in 10<\/strong> : <\/p>\n\n\n\n- headache<\/li>
- rash.<\/li><\/ul>\n\n\n\n
Common <\/strong>side effects are<\/strong><\/p>\n\n\n\nMay affect up to 1 in 10<\/strong> users: <\/p>\n\n\n\n- aggression or irritability<\/li>
- drowsiness or drowsiness<\/li>
- dizziness<\/li>
- tremors or tremors<\/li>
- sleep disorders ( insomnia )<\/li>
- feelings of upset<\/li>
- diarrhea<\/li>
- dry mouth<\/li>
- nausea or vomiting<\/li>
- fatigue<\/li>
- back or joint pain or elsewhere.<\/li><\/ul>\n\n\n\n
Uncommon <\/strong>side effects are<\/strong><\/p>\n\n\n\nMay affect up to 1 in 100<\/strong> users:<\/p>\n\n\n\n- clumsiness and lack of coordination ( ataxia )<\/li>
- double vision or blurred vision<\/li>
- abnormal hair loss or thinning ( alopecia )<\/li>
- skin rash or sun damage after exposure to sun or artificial light ( photosensitivity ).<\/li><\/ul>\n\n\n\n
Rare <\/strong>side effects are<\/strong><\/p>\n\n\n\nMay affect up to 1 in 1,000<\/strong> users: <\/p>\n\n\n\n- a life-threatening skin reaction ( Stevens-Johnson syndrome ): (see also information at the beginning of section 4)<\/em><\/li>
- a group of symptoms that include: fever, nausea, vomiting, headache, neck stiffness and extreme sensitivity to bright light. This may be due to an inflammation of the membrane that protects the brain and spine ( meningitis ). <\/em>These symptoms usually go away when treatment is stopped. Contact your doctor<\/strong> if symptoms persist or worsen.<\/li>
- rapid, uncontrolled eye movements ( nystagmus )<\/em><\/li>
- itching of the eyes with secretions and crusts on the eyelids ( conjunctivitis )<\/em> .<\/li><\/ul>\n\n\n\n
Very rare <\/strong>side effect s<\/strong><\/p>\n\n\n\nMay affect up to 1 in 10,000<\/strong> users: <\/p>\n\n\n\n- a life-threatening skin reaction (toxic epidermal necrolysis \ud83d\ude42 (see also information at the beginning of section 4)<\/em><\/li>
- drug reaction with eosinophilia and systemic symptoms: <\/li>
- (see also the information at the beginning of section 4)<\/em><\/li>
- elevated temperature (fever): (see also information at the beginning of section 4)<\/em><\/li>
- swelling around the face ( edema )<\/em> or swollen glands in the neck, armpit or groin ( lymphadenopathy ): (see also information at the beginning of section 4)<\/em><\/li>
- changes in liver function, as evidenced by blood tests, or liver failure: ( see also information at the beginning of section 4)<\/em><\/li>
- a severe disorder of blood coagulation that may cause unexpected bleeding or bruising (disseminated intravascular coagulation ): (see also information at the beginning of section 4)<\/em><\/li>
- changes that can be seen in blood samples – including decreased red blood cell count ( anemia )<\/em> , decreased white blood cell count ( leukopenia , neutropenia , agranulocytosis )<\/em> , decreased platelet count ( thrombocytopenia )<\/em> , decreased number of all these blood cell types (pancytopenia)<\/em> and a disease in bone marrow one called