Lamictal Rash From Medication: How Symptoms Look
Treatment starts with discontinuing medications
Medically reviewed by Brendan Camp, MD
Lamictal (lamotrigine) is an antiepileptic medication that works to prevent seizures but also has other uses. This medication can cause a rash, which can develop as soon as you start taking the medication, after you’ve been taking it for a while, or even after you’ve stopped taking it.
Sometimes this is a mild skin reaction that resolves, but it could be a sign of a serious and potentially fatal physical response to the medication. Lamictal rash can be treated, but you need to get medical attention right away if you start to have any signs of a rash while taking Lamictal—even if the symptoms are mild.
This article explains how you can recognize a Lamictal rash and what you should do if you start to develop any type of skin reaction or allergic response during or after Lamictal use.
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Early Lamictal Rash: Start of Symptoms
A Lamictal rash can begin anywhere on your skin. Sometimes this rash is localized on just one area of the body, or it can be generalized, affecting the face, hands, arms, feet, neck, trunk, and back.
The rash can appear as small, clustered, pinkish bumps, and it can feel itchy or slightly sore. In severe cases, blisters or peeling of the skin may develop—sometimes within just a few hours of the first signs of a rash.
Symptoms that may accompany a Lamictal rash include:
Low-grade fever
Swollen and tender lymph nodes in the neck, under the armpits, or in the groin
Swelling of the face or other areas of the body
Shortness of breath
Feeling dizzy or light-headed
Liver failure, kidney failure, or inflammation of the heart can occur. Sometimes blood tests may show eosinophilia—a high number of eosinophils, which are immune cells associated with allergic reactions.
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Complications
A Lamictal rash could be part of an allergic reaction, or part of a serious medication-induced syndrome. Lamictal, like several other antiepileptics, may cause rare, but very serious reactions that begin with a rash.
Severe reactions that can be associated with Lamictal include:
Anticonvulsant hypersensitivity syndrome (AHS): Rashes, fever, and evidence of organ involvement that can occur during or after use of antiepileptic medications
Stevens-Johnson syndrome (STS): Peeling of the skin, blisters throughout the body (including the eyes), severe fluid loss, and mineral imbalances
Toxic epidermal necrolysis (TEN): Skin peeling and blisters affecting over 30% of the body's skin surface
Drug rash with eosinophilia and systemic symptoms (DRESS): Causes a rash, lymphadenopathy (swelling of the lymph nodes), and inflammation of the lymph nodes with eosinophilia
While less common, Lamictal can trigger the onset of lupus (an autoimmune inflammatory condition) or other inflammatory conditions.
Timing of Lamictal Rash and Medication Dosage
The timing of Lamictal rash is not typically correlated with the timing of medication dosing.
Some people may develop this rash shortly after taking the first dose of Lamictal, but others might not experience the symptoms until they’ve taken Lamictal for several weeks or longer. And some people first develop a Lamictal rash after completely stopping the medication.
How Often Does Lactimal Rash Happen?
According to the manufacturer, severe skin reactions affect between 0.3% and 0.8% of children taking Lamictal, and 0.3% of adults taking Lamictal.
Risk Factors
Some people have a predisposition to developing a rash from Lamictal due to certain genes that affect immune function. Additionally, taking more than one antiepileptic medication can further increase the risk.
Lamictal and valproate are sometimes combined because they are indicated for a few of the same conditions. The combination can make the risk of an adverse reaction higher than the risk of taking either of these medications alone.
Delayed Symptoms
Research suggests that Lamictal rash can develop due to a severe immune response, or as a result of chemical reactions that can sometimes occur in the body, potentially causing a systemic reaction. These reactions can occur as Lamictal breaks down, which is why the symptoms can be delayed even after the active form of Lamictal is no longer present in the body.
How to Treat Lamictal Rash at Beginning Stages
When you start your Lamictal prescription, your healthcare provider might prepare you with instructions about what to do and where to get help if you develop a rash.
A rash that occurs in association with anti-epilepsy medication can worsen quickly, and it can be dangerous. You should not treat a Lamictal rash on your own at home.
When to Get Medical Help
If you start to develop any symptoms affecting your skin while you are taking Lamictal or any anti-seizure medication, it’s important you get medical attention right away. Do not wait to see if it will get better on its own.
Many complications are associated with SJS, DRESS, and TEN. These conditions require specialized medical care, usually in a hospital setting.
Treatment for Severe Lamictal Rash Symptoms
Treatment for a Lamictal rash may include therapies that can help alleviate the skin reaction, as well as therapies for managing the systemic effects of SJS, DRESS, or TEN. You might receive corticosteroids, which can treat the immune reaction, as well as some of the complications.
Complications and their treatments include:
Dehydration, which requires fluid replenishment that may include intravenous fluids
Electrolyte imbalance, which requires intravenous replenishment of electrolytes (charged minerals such as sodium, calcium, and potassium)
Blood pressure management
Skin loss, which might need to be treated with skin grafts
Wound care, sometimes in a burn unit, may also be necessary
Severe antiepileptic drug reactions can also predispose you to an infection. You might be treated with antibiotics if you develop a bacterial infection.
Medication Modifications After a Lamictal Rash
If you develop a Lamictal rash, your healthcare provider will give you specific guidance about when to stop taking the medication. Follow their guidance. In general, Lamictal should be stopped right away if you have a more severe rash or systemic symptoms.
Lamictal is indicated for treating epilepsy and bipolar disorder, and it’s sometimes used off-label to treat nerve pain. If you are taking Lamictal for seizure control, your healthcare team will likely prescribe another antiepileptic to replace Lamictal so that you can maintain adequate seizure control.
If you are taking this medication for the management of bipolar disorder, nerve pain, or any other condition, you will likely receive a prescription for a replacement medication that’s less likely to cause a rash.
Do Not Modify Your Dosage Without Healthcare Provider Guidance
Stopping Lamictal can have serious consequences. This is why any changes need to be under the supervision of a healthcare professional.
Potential consequences of stopping Lamictal include:
If you are taking Lamictal to control epilepsy, abruptly stopping can lead to seizures.
If you are taking Lamictal for treatment of a mood disorder, you could experience withdrawal symptoms if you stop the medication suddenly—these include tiredness and headaches. Additionally, symptoms of your mental health disorder may return.
If you are taking Lamictal for control of neuropathic pain (pain affecting the nerves), you might experience withdrawal symptoms if you stop the medication suddenly.
During the transition, while another medication is taking effect, your healthcare providers will continue to monitor your rash.
Summary
Lamictal is considered safe for adults and children, but it can cause side effects. Lamictal rash can be a sign of an allergic reaction or a severe systemic reaction to this medication.
You should contact your healthcare provider immediately if you start to develop a rash while taking Lamictal—and follow the instructions given to you regarding a Lamictal rash.
A rash associated with antiepileptic medication can develop suddenly, even if you’ve been taking the medication for months without any adverse reactions—sometimes this type of rash can even begin after you’ve completely stopped taking the medication.
When you are seen and evaluated for a Lamictal rash, your healthcare providers will determine whether you should stop the medication and whether you need to start on a replacement therapy right away. Treatment can prevent life-threatening complications.
Read the original article on Verywell Health.
