Jump to content


Click here to find a mentally interesting date at No Longer Lonely Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud




Some Crazymeds mugs to help you wash down your meds. Get mugged for at Straitjacket T-shirts for more. 11oz mugs are $13. 15oz mugs are $14.
Mentally Interesting mug
Mentally Interesting mugs
Medicated For Your Protection mug
Medicated For Your Protection mugs
Team Bipolar mug
Team Bipolar mugs
I <3 Wellbutrin mug
I <3 Wellbutrin mugs
Photo

Splitting Lamotrigine (Non-Extended-Release) Pills

lamotrigine lamictal

  • Please log in to reply
7 replies to this topic

#1 Artemisia

Artemisia

    Would-be Neurologist

  • Members
  • PipPipPip
  • 787 posts
  • Diagnoses:Depression
  • Current Meds:sertraline, cetirizine, zolpidem
  • Location:Massachusetts

Posted 21 November 2011 - 05:00 PM

I wouldn't tamper with extended release Lamictal pills with a ten-foot pole, but is it OK to split regular lamotrigine pills?

I'm asking because the main CM site suggests that it's OK, but the lamotrigine article I found on UpToDate (which I don't have access to at home) warns against splitting: "Only whole tablets should be used for dosing, round calculated dose down to the nearest whole tablet." As far as I can tell, this article isn't specifically about the XR formulation. (Is is just some cover-your-ass disclaimer on UpToDate's part?)

You'd think that the pills would be splittable, especially given how pesky Lamictal is to tirate (or there'd be lots of dosages available).


P.S. I don't take lamotrigine. I take fluoxetine for my depression. Still, I read that UpToDate article, and I was confused.
  • 0
Current meds: sertraline 100mg, cetirizine 5mg, zolpidem 2.5 mg




Enable Crazymeds to keep ranting about being crazy and taking meds. Donate some spare electronic currency you have floating around The Cloud



Stick to your treatment plan with buttons and magnets. 2.25″ $4 & 3.5″ $4.50 at Straitjacket T-shirts
Pile of Pills buttons at Straitjacket T-shirts
Pile of Pills buttons
Batshit Crazy buttons at Straitjacket T-shirts
Batshit Crazy buttons
Medicated For Your Protection buttons at Straitjacket T-shirts
Medicated For Your Protection buttons
Mentally Interesting buttons at Straitjacket T-shirts
Mentally Interesting buttons



#2 notfred

notfred

    Ready for the MCAT

  • Members
  • PipPipPipPip
  • 4,783 posts
  • Diagnoses:check out signature
  • Current Meds:check out signature
  • Location:USA

Posted 21 November 2011 - 05:13 PM

During titration my doc had me split pills.

nf
  • 0

Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
Other: Fenofibrate, Atorvastatin, Lisinopril, Hctz, Asprin, Metformin, Januvia, Ranitidine, Cetirizine, Nasalide, Montelukast
PRN's: Lorazepam, Alprazolam, Dextroamphetamine, Propranolol, Cyproheptadine, Patanol, Prednisone, Ipratropium, Ondansetron, Hydrocodone, Doxepin
Supplements: Fish Oil 6 g, Multi-vitamin/mineral, vitamin D 1,500 IU

I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

J'ai seul la clef de cette parade sauvage.
Arthur Rimbaud, Les Illuminations, Parade

"I think you are on enough medications." --my pdoc
 

Dr. Frankenstein: You know, I'm a rather brilliant surgeon. Perhaps I can help you with that hump.

Igor: What hump?

 


#3 Artemisia

Artemisia

    Would-be Neurologist

  • Members
  • PipPipPip
  • 787 posts
  • Diagnoses:Depression
  • Current Meds:sertraline, cetirizine, zolpidem
  • Location:Massachusetts

Posted 21 November 2011 - 05:16 PM

That's what I suspected. Thank you, NF!

During titration my doc had me split pills.

nf


  • 0
Current meds: sertraline 100mg, cetirizine 5mg, zolpidem 2.5 mg

#4 dymphna

dymphna

    Ready for the MCAT

  • Citizen Medical Expert
  • PipPipPipPip
  • 4,309 posts
  • Diagnoses:Suck-Ass Epilepsy, Perma-Migraine, Endocrine Hell, Associated Mood Crap
  • Current Meds:LTG 600, TPA 400, CLZ 2, Dostinex 0.5, Zoloft 0.5-1
  • Location:A Mac Computer

Posted 22 November 2011 - 01:09 AM

My personal suspicion regarding this issue is that docs et al warn against splitting due to the godawful shape of the original pill. Splitting a shield shape pill takes time, practice, and a very sharp pill cutter. If you aren't exactly on the score, the damn thing just crumbles. And at that point, your dosage isn't even - you're at 55/45 or 60/40 or whatever - not 50/50. I found it easier to simply ask for a buttload of 25mg pills while I was titrating.

Then again, my insurance isn't based on price per pill, it is based on "per prescription filled", so it wasn't a cost disincentive for me to do that. If you have similar insurance, I would ask for 25mg pills. You'll be taking more pills, but they are easier to deal with. Also, I found that I had fewer side effects (I had reactions that caused me to quit LTG 2 times - this is my 4th go-round), as the 25mgs have no dyes and fewer fillers than the shields do. I didn't switch to the shields until I was all the way up at 300mg. (I'm now on 400 for epilepsy and, funnily enough, back on little white 100mg and 50mg pills - because the EU doesn't make LTG in shield form nor in 200mg form... ).


Dymphna
  • 0

Yes, my name really is Dymphna.

 

I'm not a doctor, nurse, pharmacist, or therapist.

I can find you an answer and I won't blow smoke up your ass.

 

St. Dymphna is the Patron for brain maladies.

 

I'm the Enforcer.

 

eqnmrt.jpg

 


#5 Mr_West

Mr_West

    Would-be Neurologist

  • Citizen Medical Expert
  • PipPipPip
  • 1,521 posts
  • Diagnoses:Bipolar I
  • Current Meds:Lamictal 100mg, Bupropion 300mg
  • Location:Illinois

Posted 22 November 2011 - 04:00 AM

I wouldn't tamper with extended release Lamictal pills with a ten-foot pole, but is it OK to split regular lamotrigine pills?

I'm asking because the main CM site suggests that it's OK, but the lamotrigine article I found on UpToDate (which I don't have access to at home) warns against splitting: "Only whole tablets should be used for dosing, round calculated dose down to the nearest whole tablet." As far as I can tell, this article isn't specifically about the XR formulation. (Is is just some cover-your-ass disclaimer on UpToDate's part?)

You'd think that the pills would be splittable, especially given how pesky Lamictal is to tirate (or there'd be lots of dosages available).


P.S. I don't take lamotrigine. I take fluoxetine for my depression. Still, I read that UpToDate article, and I was confused.


Personally with Lamotrigine I wouldn't. Even it it is shaped well lamotrigine is just too picky that I'd chance it being evenly distributed in the tablet.

My personal suspicion regarding this issue is that docs et al warn against splitting due to the godawful shape of the original pill. Splitting a shield shape pill takes time, practice, and a very sharp pill cutter. If you aren't exactly on the score, the damn thing just crumbles. And at that point, your dosage isn't even - you're at 55/45 or 60/40 or whatever - not 50/50. I found it easier to simply ask for a buttload of 25mg pills while I was titrating.

Then again, my insurance isn't based on price per pill, it is based on "per prescription filled", so it wasn't a cost disincentive for me to do that. If you have similar insurance, I would ask for 25mg pills. You'll be taking more pills, but they are easier to deal with. Also, I found that I had fewer side effects (I had reactions that caused me to quit LTG 2 times - this is my 4th go-round), as the 25mgs have no dyes and fewer fillers than the shields do. I didn't switch to the shields until I was all the way up at 300mg. (I'm now on 400 for epilepsy and, funnily enough, back on little white 100mg and 50mg pills - because the EU doesn't make LTG in shield form nor in 200mg form... ).


Dymphna


http://drugtopics.mo...e/detail/721902

I've probably posted this link on another pill splitting forum. There is some pretty solid evidence coming out that even evenly split pills aren't normally even doses. I'd still split a prn without batting an eye, but stuff taken daily gets tricky.

For something taken regularly if you split pills the best way is probably going to be splitting the pills on at a time taking of half for a dose and the other half with your next dose. That guarantees that between the two doses you can guarantee how much you have taken. Depending on the drug if you are at a steady state it may not matter much. There seems to be a consensus building that splitting the whole bottle when you get home can be be a recipe for disaster even with a trained eye and practice.

When people design and manufacturer even the dumb non-extended release tablets, there's normally an excess of binder for the amount of drug contained. The ways that tablets are pressed and manufactured can often mean that in two tablets with an identical concentration of drug, the drug can be distributed differently within the tablet (actually less of a concern with extended release).
  • 0
________________________________________________________________________________
Not a medical professional. I have been asked whether I am a magician or scientist. Maybe I am neither, maybe I'm both. Take things I've written more than a year or two ago with more than a couple grains of salt, because people learn. I mean who thinks that when the house cat finally catches that bunny rabbit in the yard the bunny is going to kick the cat's ass, but once you see it you have to reconcile it with your existing view of the world.

CYP 2D6 *10, *39

#6 susan2u

susan2u

    DIY Trepanist

  • Members
  • Pip
  • 47 posts
  • Diagnoses:bipolar2 with major depression, anxiety, ptsd, and many more
  • Current Meds:zoloft, lamictal, diazepam, melatonin, levothryroxine, aspirin
  • Location:kansas

Posted 22 November 2011 - 04:03 PM

i split mine. my pills are 200mg. i take 200mg in the morning and 100mg in the afternoon. and its the generic brand.
  • 0
past meds: cymbalta, geodon, effexor, paxil, celexa, prozac, lithium, tegretol, zoloft, buspar, xanax, klonopin, ambien, trazodone, lexapro, depakote.
will have to think more and come back and edit this.

#7 Artemisia

Artemisia

    Would-be Neurologist

  • Members
  • PipPipPip
  • 787 posts
  • Diagnoses:Depression
  • Current Meds:sertraline, cetirizine, zolpidem
  • Location:Massachusetts

Posted 22 November 2011 - 04:24 PM

And it seems to be working for you, S2u?

i split mine. my pills are 200mg. i take 200mg in the morning and 100mg in the afternoon. and its the generic brand.


  • 0
Current meds: sertraline 100mg, cetirizine 5mg, zolpidem 2.5 mg

#8 susan2u

susan2u

    DIY Trepanist

  • Members
  • Pip
  • 47 posts
  • Diagnoses:bipolar2 with major depression, anxiety, ptsd, and many more
  • Current Meds:zoloft, lamictal, diazepam, melatonin, levothryroxine, aspirin
  • Location:kansas

Posted 23 November 2011 - 06:27 PM

yeah. except i think the time sucks. but i have had no trouble with splitting it that i know of.
  • 0
past meds: cymbalta, geodon, effexor, paxil, celexa, prozac, lithium, tegretol, zoloft, buspar, xanax, klonopin, ambien, trazodone, lexapro, depakote.
will have to think more and come back and edit this.



0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users




Keep Crazymeds on the air. Donate some spare electronic currency you have floating around The Cloud





Keep up with Crazymeds and and/or my slow descent into irreparable madness boring life. Pick your preferred social media target(s):
Follow Jerod Poore on Facebook
Wear my StraitjacketBatshit Crazy Blog
Crazymeds | Promote Your Page Too
Play Dress-Up with your Imaginary FriendsCrazymeds: The Blog


Just a few designs from our Crazymeds' Clothes Line. See more ways to let my meds express your feelings at Straitjacket T-shirts. Shirts, hoodies & more, $15-$43. Or search the Amazon for your retail Nirvana.
Batshit Crazy shirt
Batshit Crazy shirts
Mentally Interesting shirt
Mentally Interesting shirts
Medicated For Your Protection shirt
Medicated For Your Protection shirts
Breakfast of Champions shirt
Breakfast of Champions shirts