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Once-daily lamotrigine extended release for epilepsy management

In order to improve patient compliance and decrease toxicity of antiepileptic drugs (AEDs), the recent strategy for epilepsy management has been to expand the use of extended-release (XR) formulations. Lamotrigine (LTG), an AED with broad efficacy, is available as a twice-daily immediate-release formulation. A once-daily XR formulation of LTG (LTG-XR) is currently being developed. LTG-XR tablets contain a modified-release eroding matrix formulation designed to control the dissolution rate of LTG. The bioavailability of LTG-XR is similar to that of LTG-IR, except in patients taking enzyme-inducing AEDs in whom the bioavailability of LTG-XR is 21% lower. In adult drug-resistant partial epilepsy, adjunctive LTG-XR effectively reduces the seizure frequency and is well tolerated. Trials in an elderly population with partial epilepsy as well as in adults with refractory primary tonic–clonic seizures are underway. Once-daily LTG-XR may represent a future option for patients with poor compliance to twice-daily immediate-release LTG.