Lamictal with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Lamictal (Lamotrigine). Most antibiotics do not interfere meaningfully with Lamotrigine at 25mg, 50mg, 100mg, 200mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Neurological Medications agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Lamotrigine at 25mg, 50mg, 100mg, 200mg.
Practical guidance
According to the prescribing information for Lamotrigine, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Lamictal is co-administered. Adjusted 25mg, 50mg, 100mg, 200mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Lamictal during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Lamotrigine is metabolised and may need a temporary 25mg, 50mg, 100mg, 200mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Lamictal regimen.
Will antibiotics make Lamictal stop working? ▾
Most antibiotics do not affect Lamictal efficacy. Rifampicin and a few others can lower Lamotrigine levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Lamictal
- With alcoholLamictal and alcohol — is it safe to drink?
- With foodShould Lamictal be taken with food?
- Side effectsLamictal side effects: common, rare and warning signs
- Dosage guideLamictal dosage guide: how much to take and when
- OnsetHow fast does Lamictal start working?
- DurationHow long does Lamictal last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.