Lamotrigine for facial pain

If you have chronic pain in the face, we might prescribe you a medicine called lamotrigine. Chronic pain (also called persistent pain) is long-term pain that lasts for more than 3 months.

Lamotrigine is a medicine used to treat epilepsy and, sometimes, chronic facial pain.

Lamotrigine is only available on prescription. Always follow the amount prescribed (dose) by your doctor, and read the leaflet that comes with your medicine.

Taking an unlicensed medicine

The use of lamotrigine for treating chronic facial pain is unlicensed. This means that the manufacturer of the medicine has not specified it can be used in this way, but there is evidence that it works to treat this particular condition.

Read more about unlicensed medicines, or you can contact our pharmacy medicines helpline if you have any questions or concerns.

Taking lamotrigine

Lamotrigine comes as chewable or dissolvable tablets. You can swallow them whole with water, chew them, or mix them with water or juice to make a drink.

You can take lamotrigine with or without food.

If you take lamotrigine 2 times a day, try to space your doses evenly through the day. For example, first thing in the morning and in the evening.

It can take up to 6 weeks for lamotrigine to start working. When you start taking lamotrigine, it is important to increase the dose slowly as this will help reduce or stop some side effects.

When you find a dose that suits you, it will usually stay the same. Not everyone will need to have the maximum dose, which is 200mg, 2 times a day.

How much to take

Week Morning Evening
1 and 2 25mg --
3 25mg 25mg
4 50mg 25mg
5 50mg 50mg
6 75mg 75mg
7 onwards 100mg 100mg

If you forget to take the medicine

If you take lamotrigine 1 time each day

Take the missed dose as soon as you remember. If it is less than 12 hours until your next dose is due, leave out the missed dose and take your next dose as normal.

If you take lamotrigine 2 times each day

Take the missed dose as soon as you remember. If it is less than 8 hours before the next dose is due, it is better to leave out the missed dose and take your next dose as normal.

Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget to take your tablets for more than 5 days in a row, speak to your hospital doctor, as you'll need to start on a low dose again and gradually increase it to your usual dose.

Side effects of lamotrigine

Like all medicines, lamotrigine can cause side effects, although not everyone gets them.

The most common side effects of lamotrigine are skin rashes and headaches.

Skin rashes

It's common to get a skin rash with lamotrigine. Most skin rashes are not serious.

Tell a doctor immediately if:

you develop a rash, as this can develop into a life-threatening condition called Stevens-Johnson syndrome.

It's more likely to happen in the first 8 weeks, or when the dose is increased too quickly. It can also happen if lamotrigine is stopped suddenly and then restarted at the same dose without reducing the dose and increasing it slowly again.

To help prevent the chance of you getting a rash that could be confused with Stevens-Johnson syndrome, it is good to not start any new medicines, foods or products during the first 3 months of treatment with lamotrigine.

Try to not start lamotrigine within 2 weeks of a viral infection, vaccination or rash caused by something else.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and go away by themselves.

If these side effects bother you or do not go away, keep taking the medicine, but talk to your doctor:

  • headaches
  • feeling drowsy, sleepy or dizzy
  • aggression, or feeling irritable or agitated
  • shaking or tremors
  • difficulty sleeping
  • diarrhoea
  • feeling sick (nausea) or being sick (vomiting)

Serious side effects

Very few people have serious side effects to lamotrigine.

Tell a doctor immediately if you have:

  • thoughts of harming or killing yourself (a few people taking lamotrigine for bipolar disorder have had suicidal thoughts, and this can happen after only a few weeks of treatment)
  • worsening seizures (if you take lamotrigine for epilepsy)
  • unexpected bruising or bleeding, a high temperature (fever) or sore throat (these could be warning signs of a blood disorder)
  • a stiff neck, headaches, feeling sick or being sick, a high temperature and extreme sensitivity to bright light (these could be signs of meningitis)

Serious allergic reaction

In rare cases, it is possible to have a serious allergic reaction (anaphylaxis) to lamotrigine.

Contact your GP or go to the nearest A&E immediately if:

  • you get a skin rash that might include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are not all the side effects of lamotrigine. For a full list see the leaflet inside your medicine packet. You can report any suspected side effects to the UK safety scheme.

Pregnancy and breastfeeding

There's no firm evidence that lamotrigine is harmful to an unborn baby. But for safety, your doctor will only advise you to take it in pregnancy if the benefits of the medicine outweigh the risks.

Lamotrigine can be taken while you're breastfeeding.

Taking lamotrigine with other medicines

Some medicines interfere with each other and increase the chance of side effects. Tell your doctor about any other medicines you are taking. Your doctor might need to change your dose of lamotrigine.

Repeat prescriptions

Repeat prescriptions will only be issued by the hospital clinic.

Resource number: 4832/VER1
Last reviewed: October 2019
Next review due: October 2022

Contact us

If you have any questions about your medicine for facial pain, please contact the oral medicine team.

Phone: 020 7188 4399, Monday to Friday, 9am to 5pm

You can also contact our pharmacy medicines helpline.

Phone: 020 7188 8748, Monday to Friday, 9am to 5pm

Email: [email protected]

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

Is this health information page useful?