Adding lamotrigine to topiramate.
- Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
- Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.
- This combination of drugs may have possible synergistic effects. However, the pharmacokinetic drug interactions will influence the plasma levels. Dose adaptation will be recommended for this combination.
- Topiramate does not cause a significant change in lamotrigine levels.  Start topiramate according to the general dosing advice.
- Farmacotherapeutisch Kompas - topiramaat (dutch)
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- Farmacotherapeutisch Kompas; Toxicologie (dutch)
- Drugs.com lamotrigine
- Berry at al, Lack of an effect of topiramate on lamotrigine serum concentrations. Epilepsia 2002;43(8):818-23
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