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SJS/TEN warning with lamotrigine — GPhC CRA MCQ

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HardAdverse Drug Reactions and Drug SafetySJS/TEN warning with lamotrigineGPhC CRA

A 26-year-old woman started lamotrigine three weeks ago and now has a widespread blistering rash with mouth ulcers and fever. She asks whether to keep taking it until her GP appointment. What is the most appropriate action?

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Correct answer: E — Stop lamotrigine and seek emergency medical assessment

A blistering rash with mucosal involvement and fever suggests a serious cutaneous adverse reaction such as Stevens-Johnson syndrome. Lamotrigine is a recognised cause, particularly during initiation or rapid titration. The medicine should be stopped and emergency assessment arranged. Rechallenge or dose increase would be dangerous.

Reference: BNF; MHRA