Epilepsy–
Table-1: Escalation Regimen for Lamotrigine in Patients Older than 12 Years with Epilepsy

Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg every day
• In patients taking Valproate: 25 mg every other day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg/day

Weeks 3 & 4:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg/day
• In patients taking Valproate: 25 mg every day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg/day (in 2 divided doses)

Week 5 onward to maintenance:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: Increase by 50 mg/day every 1 to 2 weeks
• In patients taking Valproate: Increase by 25 to 50 mg/day every 1 to 2 weeks
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: Increase by 100 mg/day every 1 to 2 weeks

Usual maintenance dose:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 225 to 375 mg/day (in 2 divided doses)
• In patients taking Valproate: 100 to 200 mg/day with Valproate alone 100 to 400 mg/day with Valproate and other drugs that induce glucuronidation (in 1 or 2 divided doses)
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 to 500 mg/day (in 2 divided doses)

Table-2: Escalation Regimen for Lamotrigine in Patients Aged 2 to 12 Years with Epilepsy

Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
• In patients taking Valproate: 0.15 mg/kg/day in 1 or 2 divided doses
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 0.6 mg/kg/day (in 2 divided doses)

Weeks 3 & 4:
In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 0.6 mg/kg/day (in 2 divided doses)

• In patients taking Valproate: 0.3 mg/kg/day in 1 or 2 divided doses
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 1.2 mg/kg/day (in 2 divided doses)

Week 5 onward to maintenance:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.6 mg/kg/day
• In patients taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 0.3 mg/kg/day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: The dose should be increased every 1 to 2 weeks as follows-calculate 1.2 mg/kg/day

Usual maintenance dose:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 4.5 to 7.5 mg/kg/day (maximum 300 mg/day in 2 divided doses)
• In patients taking Valproate: 1 to 3 mg/kg/day with Valproate alone 1 to 5 mg/kg/day (maximum 200 mg/day in 1 or 2 divided doses)
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 5 to 15 mg/kg/day (maximum 400 mg/day in 2 divided doses)

Table-3: The Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4) with Epilepsy

Weeks 1 & 2:

• If the patients weight is 6.7 kg to 14 kg: 2 mg every other day
• If the patients weight is 14.1 kg to 27 kg: 2 mg every day
• If the patients weight is 27.1 kg to 34 kg: 4 mg every day
• If the patients weight is 34.1 kg to 40 kg: 5 mg every day

Weeks 3 & 4:

• If the patients weight is 6.7 kg to 14 kg: 2 mg every day
• If the patients weight is 14.1 kg to 27 kg: 4 mg every day
• If the patients weight is 27.1 kg to 34 kg: 8 mg every day
• If the patients weight is 34.1 kg to 40 kg: 10 mg every day

Bipolar disorder–

Table-4: Escalation Regimen for Lamotrigine in Adults with Bipolar Disorder
Weeks 1 & 2:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 25 mg daily
• In patients taking Valproate: 25 mg every other day
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 50 mg daily

Weeks 3 & 4:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 50 mg daily
• In patients taking Valproate: 25 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 100 mg daily (in divided doses)

Week 5:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 100 mg daily
• In patients taking Valproate: 50 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 200 mg daily (in divided doses)

Week 6:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
• In patients taking Valproate: 100 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: 300 mg daily (in divided doses)

Week 7:

• In patients not taking Carbamazepine, Phenytoin, Phenobarbital, Primidone or Valproate: 200 mg daily
• In patients taking Valproate: 100 mg daily
• In patients taking Carbamazepine, Phenytoin, Phenobarbital or Primidone and not taking Valproate: up to 400 mg daily (in divided doses)