Lamotrigine may be associated with increased risk of cardiac arrhythmias, FDA warns

By Saadia Aslam

An FDA review of study findings showed a potential increased risk of cardiac arrhythmias in patients with pre-existing cardiac disease who are taking lamotrigine. FDA reviewed in vitro studies of lamotrigine after receiving reports of abnormal electrocardiographic findings, chest pain, loss of consciousness and cardiac arrest.

This information was first added to the lamotrigine prescribing information and Medication Guides in October 2020, which has been updated.

Patients have been advised to not stop taking their medications without a medical review first. However, if they experience any palpitations, dyspnoea or dizziness or syncope then to contact a health care professional right away or attend the emergency department. Clinicians are advised to consider if the potential benefits of treatment with lamotrigine outweigh the risk of potentially life threatening arrhythmias in patients with cardiac conditions.

The risk of arrhythmias may increase further if used in combination with other sodium channel blockers. Note: Other sodium channel blockers approved for epilepsy, bipolar disorder, and other indications should not be considered safer alternatives to lamotrigine in the absence of additional information.


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