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Epilepsy missed doses — GPhC CRA MCQ

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ModerateCNS TherapeuticsEpilepsy missed dosesGPhC CRA

A 21-year-old woman taking lamotrigine 100mg twice daily for epilepsy has missed three days of treatment after gastroenteritis. She is now well and asks whether to restart the full dose. What would you advise the patient?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Contact the epilepsy prescriber or urgent care service before restarting

Lamotrigine requires careful titration because rapid dose escalation can increase the risk of serious rash. After a treatment interruption, restarting advice depends on the length of interruption and individual regimen. The pharmacist should seek specialist or prescriber advice rather than advise full-dose restart. Doubling the dose is unsafe.

Reference: BNF; NICE CKS