Can I Use Old Lamotrigine IR Instead of XR?
I’m a 35-year-old female managing bipolar disorder alongside hypertension. Currently, my medications include 300mg of lamotrigine XR, 25mg of quetiapine, 50mg of metoprolol, and a multivitamin. Unfortunately, there's been a shortage of lamotrigine XR at my pharmacy as well as others nearby. They mentioned they might have it back in stock by tomorrow, although Friday seems more likely. I'm waiting for my psychiatrist to return my call, but given his busy schedule, I’m not expecting to hear from him today. Previously, I had some 200mg immediate-release (IR) lamotrigine pills before my switch to the extended-release (XR) version. As far as I recall, I used to take 100mg in the mornings and 200mg in the evenings. These IR pills are now 2 years old, but from what I’ve researched, they should remain effective for up to 3 years if stored properly. They’ve been kept in their original bottle in a drawer, away from extreme temperatures. I’m wondering if it would be acceptable to temporarily revert to the IR formulation for a few days while maintaining the same total dosage. Following that, I would switch back to the XR when it becomes available. I believe this would be more beneficial than taking no medication at all, but I’m concerned about potential issues. I recognize that lamotrigine can be a complex medication at times. Thank you for your input!
Answers (1)
2/4/2026, 6:00:54 PM
OpenHealth AI
It's understandable to be concerned about maintaining your treatment plan during a medication shortage, especially with a complex condition like bipolar disorder. Transitioning temporarily to the immediate-release (IR) formulation of lamotrigine may be a reasonable solution, considering your situation.
Main Points:
- You can potentially use your older IR lamotrigine temporarily, but monitor closely for any changes in your mood or side effects.
- It’s essential to maintain the correct total dosage.
- Ensure to switch back to XR as soon as it's available to maintain the therapeutic benefits.
Explanation:
Lamotrigine is used to help stabilize mood in bipolar disorder, and the XR formulation is designed for once-daily dosing, providing steady medication levels. The IR version may require dividing the total daily dose into two or more doses. Your old IR pills are likely still effective, provided they are stored properly, as you mentioned, and the typical shelf life for such medications can indeed extend to 3 years.
However, it's essential to make sure that you are dosing correctly. Given your previous regimen of 100mg in the morning and 200mg in the evening, achieving the equivalent of your XR dosage (300mg total) may require you to adjust your dosing schedule properly with the IR version.
Next Steps:
-
Use IR Lamotrigine Temporarily: Start with the 200mg dose in the evening and 100mg in the morning to replicate your previous dosage while you wait for the XR to become available.
-
Monitor Your Symptoms: Keep a close watch on any changes in your mood, side effects, or any unexpected symptoms. If you feel any significant changes, make notes to discuss with your psychiatrist.
-
Return to XR: As soon as the XR version is back in stock, switch back to that formulation to keep your medication regimen consistent.
-
Stay in Touch with Your Psychiatrist: While waiting for your call back, don’t hesitate to contact the pharmacy again for updates or consult them regarding transitioning back to XR once it’s available.
If you feel any significant side effects or worsening of your bipolar symptoms, please seek medical help promptly. Your mental health stability is the priority, and trying to manage your medication in the best way possible during this shortage is essential. Let me know if you need more guidance or have further questions!
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