Posted by ed_uk2010 on January 28, 2015, at 12:18:36
In reply to Re: Blood levels: Marplan + Lamictal vs Lamictal alone, posted by PeterMartin on January 28, 2015, at 8:03:35
>I think an old writeup about Lamictal clearance from Crazymeds is what I've been ruminating over. It mentions how the half life/levels can vary greatly/etc due to interactions.
It can, and Lamictal does have quite a few interactions, but not with everything.
As far as I can tell, the potential for interaction with isocarboxazid has not received any study. Among the MAOIs, only the possibility of interaction with phenelzine, the most closely related drug, has been examined (minimally).
GSK, who manufacture Lamictal, list the interactions which have been studied:
http://www.medicines.org.uk/emc/medicine/4228#INTERACTIONS
'.....experiments also suggested that metabolism of lamotrigine was unlikely to be inhibited by..... phenelzine (Nardil)....'
>Had I only gotten down and not gotten so itchy I probably wouldn't be questioning it but the itching has been noticeable.You said you felt other symptoms at high lamotrigine levels before though, I think? You also mentioned feeling better when you took a bit extra lamotrigine yesterday.
I don't think you have anything to worry about with respect to lamotrigine levels. If you need to adjust lamotrigine you can do so in a few weeks' time but you should probably wait to find out how you do just by stopping isocarboxazid first. Due to the gradual increase in levels of active MAO, the full effects of stopping isocarboxazid will not appear straight away.
The fact that you've been on Lamictal long-term, with and without isocarb, suggests that the itching is not representative of anything serious. In addition, you're only on a fairly low dose. It doesn't sound like you have a rash. Perhaps it would help to take any antihistamine for a couple of weeks. Cetirizine 10mg per day would be suitable.
>My insurance (CVS caremark) dropped Marplan Jan 1st and they don't cover any others in the class. I couldn't tolerate Parnate (spiked BP each dose). Nardil would be expensive but potentially doable out of pocket. The other alt would be having my doctor write a letter of medical necessity and see if I get continued coverage.
If you do need to restart Marplan at some point, would you be eligible for the manufacturer's assistance scheme?
http://marplan.com/patient-assistance-program/
Glad to hear about the weight loss. It can be quite motivating :)
Take care.
poster:ed_uk2010
thread:1075628
URL: http://www.dr-bob.org/babble/20150102/msgs/1075668.html