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Although estrogen-containing oral contraceptives have been shown to increase the clearance of lamotriginesee CLINICAL PHARMACOLOGYno adjustments to the recommended dose-escalation guidelines for LAMICTAL should be necessary solely based on the use of estrogen-containing oral contraceptivesThereforedose escalation should follow the recommended guidelines for initiating adjunctive therapy with LAMICTAL based on the concomitant AED or other concomitant medicationssee Table 1 or Table 5See below for adjustments to maintenance doses of LAMICTAL in women taking estrogen-containing oral contraceptives.

Lamotrigine binds to melanin-containing tissuese.gin the eye and pigmented skinIt has been found in the uveal tract up to 52 weeks after a single dose in rodents.

In bipolar disorderafter remission from an acute episode of mania or depressiona person is at an especially high risk of relapse for about six monthsThuscontinuation and maintenance ofongoingtherapy is often recommended as treatment for bipolar disorder.

The net effects of drug interactions with lamotrigine are summarized in Tables 13 and 15followed by details of the drug interaction studies below.

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