Pharmacokinetics

The oral bioavailability of lamotrigine approaches 100 per cent, and absorption is unaffected by food. Peak plasma concentration is reached approximately 2 to 3 h after an oral dose. It has a linear kinetic profile at the usual therapeutic doses. The half-life of lamotrigine is approximately 30 h, but is altered by the presence of other antiepileptic drugs (see later). Plasma protein binding is approximately 55 per cent. Lamotrigine is metabolized by the liver to an inactive glucuronide conjugate, and then excreted in the urine. The clearance of lamotrigine may be reduced in patients with renal impairment and Gilbert's syndrome, and these individuals may benefit from dosage reduction.(33)

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