Two medicines, side by side
Topiramate vs lamotrigine
Topiramate and lamotrigine are both labeled for seizures and epilepsy. Drugs@FDA records approvals of topiramate since 1996 and of lamotrigine since 1994. Pharmacies paid $0.0567 per topiramate 100 mg tablet and $0.0268 per lamotrigine 25 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 topiramate FDA label on DailyMed (effective June 1, 2026); the lamotrigine FDA label on DailyMed (effective October 10, 2025).
Highlights of the topiramate record
Topiramate (Topamax) · label of June 1, 2026
Used for
From the label: indicationsTopiramate is indicated for: Epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older (1.1); adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox- Gastaut syndrome in patients 2 years of age and older (1.2) Preventive treatment of migraine […]
On the market
- Earliest approval on file
- December 24, 1996
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0567 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
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
Source: FDA drug labels via openFDA (Topiramate label of June 1, 2026, Lamotrigine label of October 10, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do topiramate and lamotrigine differ on the record?
Only the lamotrigine label carries a boxed warning.
How each works, in its label's words: Topiramate, “The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to …”; Lamotrigine, “The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown.”
Generics: topiramate since 2003; lamotrigine since 2006 (Drugs@FDA).
| Topiramate | Lamotrigine | |
|---|---|---|
| Labeled for | Seizures and epilepsy, Migraine | Seizures and epilepsy, Bipolar disorder |
| Pharmacologic class | n/a | Anti-epileptic Agent, Mood Stabilizer |
| How it works (label) | The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and the … | The precise mechanism(s) by which lamotrigine exerts its anticonvulsant action are unknown. |
| Half-life (label) | The mean plasma elimination half-life is 21 hours after single or multiple doses. | n/a |
| Earliest approval on file (Drugs@FDA) | December 24, 1996 | December 27, 1994 |
| First generic approved | December 17, 2003 | June 21, 2006 |
| Generic labelers (NDC) | 47 labelers | 49 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0567 per tablet (Topiramate 100 mg tablet) | $0.0268 per tablet (Lamotrigine 25 mg tablet) |
| 12-month price change | -10% | -12% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 10 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 91,067 | 130,994 |
| DEA schedule | none | none |
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 do the labels say about using others of their kind?
Topiramate label, drug interactionsBecause of the potential of topiramate to cause CNS depression, as well as other cognitive and/or neuropsychiatric adverse reactions, topiramate should be used with extreme caution if used in combination with alcohol and other CNS depressants.
Source: FDA drug labels via openFDA
What next?
- Alternatives to topiramate
- every medicine labeled for the same conditions