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Is It Safe To Take Cocodamol Along With Oxcarbazepine And Lamotrigine?

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Posted on Mon, 15 Jun 2015
Question: Thank you I just need some advice. I am under the care of UCH London hospital for unilateral neuralgiform facial pain with autonomic features, (Suna). I had been on Carbamazepine for some many years and it was decided the time had come to try another medication. Having seen the doctor at UCH London I firstly went on a drug called Oxcarbazepine for some weeks but it really did not help much with the pain. I was firstly told years ago I had Trigeminal neuralgia. Having tried the first drug I was then told they would try Lamotrigine. Of course I had to wean myself of the first one by reducing gradually. The initial treatment was 300mg am , lunchtime, dinnertime, and 2 tablets 600mg nightime.
I began to reduce the tablets and have got to the last one yesterday hoping to start today on Lamotrigine tonight. However, during today the pain was extremely painful and I had to take 1 tablet of of Oxcarbazepine and I am now in doubt whether it would be safe to take Lamotrigine as I had taken the tablet of the other drug today. I have also, with my GP ok taking Cocodomol as a painkiller. Also, the side effects having read the pamphlet inside the box, seem rather frightening and worry about them. As you are no doubt aware I have a strict timetable for taking the new drug by gradually increasing by 25mg for 2 weeks at night , 25mg for 7 days twice a day and it goes on increasing by 25mg every 7 days twice a day up to XXXXXXX dose of 200 mg. Please advise me what I should do, I would be grateful as the pain is gradually increasing now.
doctor
Answered by Dr. Olsi Taka (4 hours later)
Brief Answer:
You can start Lamotrigine.

Detailed Answer:
I read your question carefully and I understand your concern.

Regarding the issue of being able to start Lamotrigine today, you can certainly start the scheme you were advise no worry. Actually usually it is started before completely interrupting the other drug, gradually lowering the dose of one and increasing the dose of the other, so your doctor has already been more careful than usual on this one.
You can also take cocodamol although it's not that effective, both lamotrigine and oxcarbazepine also decrease the effect of the paracetamol (included in the cocodamol tablet) but there is still the codeine.

As for the side effects, well yes every drug can have its share of side effects, but only in a percentage of patients. While time will tell whether you'll have any issues with lamotrigine, I can say that apart from skin reactions other problems are rare and generally I would consider it a safer drug than say the Carbamazepine you've been on for many years.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (3 hours later)
On the dispensing label on the box of the drug it says to take 25mg at night. ~W~ill it be ok to take now and not have to wait until tonight as pain is very bad at the moment. Thank you so much.
doctor
Answered by Dr. Olsi Taka (31 minutes later)
Brief Answer:
You can take it earlier

Detailed Answer:
It will be ok to take it earlier, no harm will come from that. You can take it tomorrow in the afternoon and continue in the evening thereafter.

In terms of relieving your pain though I doubt that that initial dose will be very effective, it will take some time and usually higher doses.

Hopefully the cocodamol will help in the meanwhile.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (1 hour later)
The label on the box of tablets states 25mg to be taken at night for 2 weeks. Is it important that they are taken at night in the first instance because I would really like to take one now.
Thank you so much Doctor for your help and advice. I hate taking new tablets and I am afraid that I do worry about things but again thank you very much for yhour h
doctor
Answered by Dr. Olsi Taka (14 minutes later)
Brief Answer:
Read below

Detailed Answer:
You can take one tablet now, no worry. I thought I had explained that, perhaps you missed my answer or I didn't express myself well enough, sorry if that was the case.

Thank you for your kind appreciative words, I hope Lamotrigine will gradually make you feel better.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Is It Safe To Take Cocodamol Along With Oxcarbazepine And Lamotrigine?

Brief Answer: You can start Lamotrigine. Detailed Answer: I read your question carefully and I understand your concern. Regarding the issue of being able to start Lamotrigine today, you can certainly start the scheme you were advise no worry. Actually usually it is started before completely interrupting the other drug, gradually lowering the dose of one and increasing the dose of the other, so your doctor has already been more careful than usual on this one. You can also take cocodamol although it's not that effective, both lamotrigine and oxcarbazepine also decrease the effect of the paracetamol (included in the cocodamol tablet) but there is still the codeine. As for the side effects, well yes every drug can have its share of side effects, but only in a percentage of patients. While time will tell whether you'll have any issues with lamotrigine, I can say that apart from skin reactions other problems are rare and generally I would consider it a safer drug than say the Carbamazepine you've been on for many years. I remain at your disposal for other questions.