Two medicines, side by side
Lamotrigine vs lacosamide
Lamotrigine and lacosamide are both labeled for seizures and epilepsy. Drugs@FDA records approvals of lamotrigine since 1994 and of lacosamide since 2008. Pharmacies paid $0.0268 per lamotrigine 25 mg tablet and $0.174 per lacosamide 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Lamotrigine's other strengths are brand-only: $2.86 per mL (Subvenite 10 mg/mL suspension). Only the lamotrigine label carries a boxed warning.
Check it at the source: the lamotrigine FDA label on DailyMed (effective October 10, 2025); the lacosamide FDA label on DailyMed (effective May 12, 2026).
Highlights of the lamotrigine record
Lamotrigine (Lamictal) · label of October 10, 2025
SERIOUS SKIN RASHES LAMICTAL can cause serious rashes requiring hospitalization and discontinuation of treatment. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.3% to 0.8% in pediatric patients (aged 2 to 17 years) and 0.08% to 0.3% in adults receiving LAMICTAL. One rash-related death was reported in a prospectively followed cohort of 1,983 pediatric patients (aged 2 to 16 years) with epilepsy taking LAMICTAL as adjunctive therapy.
Used for
From the label: indicationsLAMICTAL is indicated for: Epilepsy–adjunctive therapy in patients aged 2 years and older: • partial-onset seizures. • primary generalized tonic-clonic (PGTC) seizures. • generalized seizures of Lennox-Gastaut syndrome. […]
On the market
- Earliest approval on file
- December 27, 1994
- Generic labelers
- 49 labelers
- Pharmacy cost
- $0.0268 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 10
Highlights of the lacosamide record
Lacosamide (Vimpat) · label of May 12, 2026
Used for
From the label: indicationsVIMPAT is indicated for: Treatment of partial-onset seizures in patients 1 month of age and older ( 1.1 ) Adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older ( 1.2 ) 1.1 Partial-Onset Seizures VIMPAT is indicated for the treatment of partial-onset seizures in patients 1 month of age and older. 1.2 Primary Generalized Tonic-Clonic Seizures VIMPAT is indicated as adjunctive therapy in the treatment of primary generalized tonic-clonic seizures in patients 4 years of age and older. […]
On the market
- Earliest approval on file
- October 28, 2008
- Generic labelers
- 57 labelers
- Pharmacy cost
- $0.174 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
Source: FDA drug labels via openFDA (Lamotrigine label of October 10, 2025, Lacosamide label of May 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do lamotrigine and lacosamide differ on the record?
Only the lamotrigine label carries a boxed warning.
How each works, in its label's words: Lamotrigine, “The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.”; Lacosamide, “The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated.”
Generics: lamotrigine since 2006; lacosamide since 2022 (Drugs@FDA).
DEA schedule: lamotrigine none; lacosamide CV.
| Lamotrigine | Lacosamide | |
|---|---|---|
| Labeled for | Seizures and epilepsy, Bipolar disorder | Seizures and epilepsy |
| Pharmacologic class | Anti-epileptic Agent, Mood Stabilizer | n/a |
| How it works (label) | The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown. | The precise mechanism by which VIMPAT exerts its antiepileptic effects in humans remains to be fully elucidated. |
| Half-life (label) | n/a | The maximum lacosamide plasma concentrations occur approximately 1-to-4-hour post-dose after oral dosing, and elimination half-life is approximately 13 hours. |
| Earliest approval on file (Drugs@FDA) | December 27, 1994 | October 28, 2008 |
| First generic approved | June 21, 2006 | March 17, 2022 |
| Generic labelers (NDC) | 49 labelers | 57 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0268 per tablet (Lamotrigine 25 mg tablet) | $0.174 per tablet (Lacosamide 100 mg tablet) |
| 12-month price change | -12% | -15% |
| Boxed warning | Yes | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 10 | 8 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 130,994 | 36,995 |
| DEA schedule | none | CV |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to lamotrigine
- every medicine labeled for the same conditions