Overview
Lamotrigine for facial pain
If you have chronic face pain, 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 tablets that you swallow whole with water. There's also a type of tablet that you can chew, and that you can dissolve in water or juice to 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's 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 (dose)
Your doctor will tell you which dose to take and when to take it.
Example schedule
Always follow the advice given by your doctor, even if it's different from this example.
| 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's 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's less than 8 hours before the next dose is due, it's 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.
More information about the side effects of lamotrigine can be found on the NHS website.
Skin rashes
It's common to get a skin rash with lamotrigine. Most skin rashes are not serious.
Call 999 or go to your nearest A&E now if:
- you notice flu-like symptoms, followed by a severe flushing red or purple rash that spreads and forms blisters that can peel off
This can develop into a skin condition called a severe cutaneous adverse reaction or Stevens-Johnson syndrome which can be life-threatening.
These symptoms are 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's 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.
Ask for an urgent GP appointment or call 111 if you have:
- unexpected bruising or bleeding, a high temperature (fever) or sore throat (these could be warning signs of a blood disorder)
Call 999 or go to your nearest A&E now if:
- you have thoughts of harming yourself or ending your life. A few people taking lamotrigine for bipolar disorder have had suicidal thoughts, and this can happen after only a few weeks of treatment.
Serious allergic reaction
In rare cases, it is possible to have a serious allergic reaction (anaphylaxis) to lamotrigine.
Call 999 or go to your nearest A&E immediately if:
- you get a 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 your safety, your doctor will only advise you to take it in pregnancy if the benefits of taking the medicine are greater than the risks.
Lamotrigine can be taken while you're breastfeeding.
If you are pregnant or breastfeeding, speak to your doctor about taking lamotrigine. They can talk to you about the benefits and risks and help you to choose the best treatment for you and your baby.
More information about taking lamotrigine during pregnancy can be found on the NHS website.
Taking lamotrigine with other medicines
Some medicines interfere with each other and increase the chance of side effects. Tell your doctor and pharmacist about any other medicines you are taking. You should also speak to them before starting or stopping any other medicine, including medicines you buy from a pharmacy or shop, online, and any other herbal remedies. Your doctor might need to change your dose of lamotrigine.
More information about taking lamotrigine with other medicines can be found on the NHS website.
Repeat prescriptions
Repeat prescriptions will only be issued by the hospital clinic.
Resource number: 4832/VER3
Last reviewed: June 2026
Next review due: June 2029
