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Paediatric Laboratory Medicine

Lamotrigine

Clinical Significance

The exact mechanism of action is unknown. In vitro studies suggest that lamotrigine blocks voltage-sensitive sodium channels, thereby stabilizing neuronal membranes and inhibiting the presynaptic release of neurotransmitters, principally glutamate. Lamotrigine also may directly inhibit high-frequency sustained repetitive firing of sodium-dependent action potentials. 

Lamotrigine is indicated as an adjunct to other anticonvulsant medications in the treatment of partial seizures in adults 16 years of age and older with epilepsy, and in the treatment of generalized seizures of Lennox-Gastaut syndrome in adult and paediatric patients two years of age and older. Lamotrigine is indicated as monotherapy for treatment of partial seizures (in adults 16 years of age and older) following withdrawal of a concomitantly used enzyme-inducing anticonvulsant medication.

Test Name

Lamotrigine

Alternate Name/ Synonym

Lamictal

Test Code

LAMTG

Drug Class

Anticonvulsants

Division

Therapeutic Drug Monitoring - TDM

Method

HPLC

External Proficiency Testing

UKEQAS

Turn Around Time

Daily @ 14:00h

Disease/Condition

Anticonvulsant

Specimen Type

Serum, Plasma (Heparin or Citrate)

Minimum Specimen Requirements

50 uL

Optimal Collection Time

Trough: 0-30 minutes prior to dose

Storage/Transportation

4°C (transport with a cool pack if possible)

Approval is not required

CPT Codes

80299

Shipping and Contact Information

The Hospital for Sick Children
Rapid Response Laboratory
170 Elizabeth Street, Room 3642
Toronto, ON
M5G 2G3
Canada
Phone: 416-813-7200
Phone: 1-855-381-3212

Therapeutic Range

4.0–39.0 umol/L

Critical Values

Not determined