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I found a piece of my 300 mg Lamictal XR missing from a pill…

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I found a piece of...
I found a piece of my 300 mg Lamictal XR missing from a pill I found on my carpet. I have bipolar disorder which is why I take it. About a quarter of it was broken off. Our dog has been in our den but has never tried to touch any of our medicine. I do not know if she broke it off and ate it or if we stepped on it. The pill shows no signs of being damp nor are the words smeared at all. I am very careful with my drugs so I have no idea how this one pill was on the floor. It was actually found underneath a blanket that was spread out on the floor flat. We have been watching her closely and she is acting like her normal perky self. Playful and barking. I know the medication would slow her down if she actually ate some of it, but if she did eat the broken off part it would’ve slowed her down by now. She just ate her food and is acting perfectly normal. Since we don’t know if she actually ate the piece or not, what would you suggest? Unfortunately it’s the extended release so we would have to monitor her for 24 hours, unless she shows signs of distress before then. If that happens then we will take her to our emergency clinic. What do you think we should do? It is possible that we stepped on it too, but I can’t find the broken off piece. I’ve always been careful and I’m am very worried. Especially since it can possibly cause SJS.
Submitted: 5 months ago.Category: Dog
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Answered in 7 minutes by:
11/15/2017
Dog Specialist: Dr. Kara, Dog Veterinarian replied 5 months ago
Dr. Kara
Dr. Kara, Dog Veterinarian
Category: Dog
Satisfied Customers: 18,120
Experience: Over 20 years of experience as a veterinarian
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Dog Specialist: Dr. Kara, Dog Veterinarian replied 5 months ago

I'm sorry to hear that your pup may have been exposed to and eaten about 75mgs of Lamotrigine (Lamictal).

  1. How much does she weigh?
  2. How long ago did you notice the pill piece was missing?
  3. Is she taking any other medications?
  4. Is she otherwise healthy?
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Dog Specialist: Dr. Kara, Dog Veterinarian replied 5 months ago

Lamotrigine (Lamictal) is a phenyltriazine anticonvulsant used in people for seizure control and Bipolar disorder, but not in dogs due to its highly toxic effects on them.

In dogs the regular, chewable, and orally disintegrating formulas are rapidly absorbed, peak levels are within 1&1/2 hours, so even within 2 hours we would need to worry some was absorbed.

The extended release takes longer, peak levels within 4 hours.

Also the chewable & disintegrating forms may contain a sweetener called xylitol which is extremely toxic for dogs. I am assuming that because this was the XR formula it was not the disintegrating formula and doesn't contain xylitol, but I want to make sure.

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Dog Specialist: Dr. Kara, Dog Veterinarian replied 5 months ago

This drug can cause a type of electrical conduction block in the heart muscle in dogs, so we can see serious, and sometimes fatal heart arrhythmias.

Clinical signs of toxicity usually occur within 4 hours of ingestion, but in some cases it can be up to 12 hours with the extended-release formula. Signs can last as long as 24-48 hours.

You could expect to see lethargy and sleepiness at a dose as low as 7.5 mg per pound of body weight.

Heart arrhythmias are generally not seen unless the ingested dose is more than 10mgs per pound of body weight.

Life-threatening heart related signs such as arrhythmias and seizures are generally seen in dogs exposed to more than 20mgs per pound of body weight.

So if she ingested the XR formula I would expect signs by 12 hours out, she should be at least sleepy/lethargic if she ingested a toxic amount and it has been more than 12 hours.

If she possibly ate 75mgs (1/4 of a 300mg tablet) and she weighs more than 10 pounds then you may not see anything beyond mild lethargy. I would keep her away from stairs, watch her very closely, and keep her very quiet for the next 48 hours. If she remains normal by then I would expect that she either didn't eat the piece of the pill or that the amount was simply too low to affect her.

I am here to help so please let me know if you have any further questions.

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Dog Specialist: Dr. Kara, Dog Veterinarian replied 5 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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