THIS MEDICATION CAN CAUSE HARM TO YOUR BABY:
Evidence on the safety of lamotrigine during pregnancy and breastfeeding is conflicting. The combination of lamotrigine with other seizure medication may increase the risk of birth defects. It is important to weigh the pros and cons of taking this medication during pregnancy.
What is lamotrigine?
Lamotrigine is a prescription anticonvulsant medication used alone or in combination with other medications.
What is lamotrigine used to treat?
Lamotrigine is used to treat epileptic seizures including partial onset seizures, partial generalized tonic-clonic seizures, bipolar I disorder, bipolar depression, and Lennox-Gastaut syndrome in children.
How does lamotrigine work?
Lamotrigine regulates the electrical activity and release of neurotransmitters in the brain to prevent seizures.
If I am taking lamotrigine, can it harm my baby?
Lamotrigine does cross the human placenta to reach the developing baby. The Lamotrigine Pregnancy Registry analysis of data from 1992 to 2010 in infants born to mothers on lamotrigine during pregnancy reported a 2.2% risk of major birth defects during first trimester exposure to the medication. The rate of major birth defects when mothers used lamotrigine plus another epilepsy medication was 2.8%. Using a combination of medications including lamotrigine during pregnancy or taking large doses of the medication may increase the risk of birth defects. Additional registries found similar risks of birth defects with lamotrigine use during pregnancy, but concluded that a link between lamotrigine and birth defects was not conclusive. One 2006 study linked lamotrigine use during pregnancy to an increased risk of cleft palate; however, other studies did not find an increased risk of cleft palate. Lamotrigine use during pregnancy has also been linked to reduced infant IQ in some studies.
If I am taking lamotrigine and become pregnant, what should I do?
Women who are attempting to conceive or become pregnant while on lamotrigine should speak with their doctor. It is only recommended to continue lamotrigine during pregnancy if the benefit to the mother outweighs the risk to the infant. Folate supplementation is recommended during pregnancy with lamotrigine exposure since the medication can decrease folate levels. Pregnancy can change the levels of lamotrigine in the mother which can increase the risk of seizures. In women who plan to become pregnant, baseline lamotrigine levels should be measured before pregnancy to help guide medication dosing during pregnancy. Women who continue to take lamotrigine during pregnancy should have continued monitoring of drug levels throughout pregnancy and after delivery. The lowest possible dose without additional medications is recommended in women continuing seizure therapy during pregnancy.
If I am taking lamotrigine, can I safely breastfeed my baby?
Lamotrigine is expected to pass into breast milk. It is estimated that infants are exposed to 2% to 20% of the mother’s dose; some reports say that breastfeeding infants can be exposed to lamotrigine concentrations as high as 50% of the mother’s dose. It is important to consider the risks of continuing lamotrigine during breastfeeding compared to the benefits of continuing the medication. Infants who are exposed to lamotrigine through breast milk should be monitored for adverse events such as sedation (extreme sleepiness) and rash.
If I am taking lamotrigine, will it be more difficult to get pregnant?
Lamotrigine clearance from the body can be increased by oral contraceptives and pregnancy. No information on the reproductive effects of lamotrigine in males is available.
If I am taking lamotrigine, what should I know?
Lamotrigine should only be used during pregnancy if the benefits to the mother outweigh the risks to the developing baby. Although the risk of negative effects in infants is considered low,the combination of lamotrigine with other seizure medications may increase the risk of birth defects. Mothers who continue breastfeeding while on lamotrigine should monitor their baby for adverse effects.
If I am taking any medication, what should I know?
This report provides a summary of available information about the use of anticonvulsants during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert report about epilepsy here, reports about bipolar disorder here, and reports about the individual medications used to treat seizure disorders here. Additional information can also be found in the resources below.
For more information about lamotrigine during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link:
Glaxo Smith Kline: Lamictal Prescribing Information
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.