Supplements and Lamotrigine.
Lamotrigine, sold under the brand name Lamictal, is an antiepileptic drug. Several agents in this class are strong CYP inducers or inhibitors.
Lamotrigine is an antiepileptic medicine. The class is heterogeneous. Enzyme inducers (carbamazepine, phenytoin, phenobarbital) drop plasma levels of many medicines given alongside. Enzyme inhibitors (valproate) raise them. The newer agents (levetiracetam, lacosamide) have quieter interaction profiles. The supplement interactions of greatest clinical importance. St John's Wort is excluded with the inducer antiepileptics on top of an already complex CYP picture. Folate at high doses competes with the folate depletion that antiepileptics drive, in a way that needs neurology team input rather than community pharmacy. Calcium and vitamin D status matter because inducer antiepileptics drive bone density loss over years; the SANAD bone substudy data is the relevant evidence base. Pregnancy planning on an antiepileptic regimen always runs through the neurology team, because of folate timing and the teratogenicity profile specific to each agent (valproate carries the highest, levetiracetam much lower).
Below are the 1 documented pair we have explicitly assessed against Lamotrigine in the Distil database: 1 green. The pairs cluster around 1 mechanism: Additive lithium load. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 28 August 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive lithium load
Green Does Lithium Orotate interact with Lamotrigine?
The reason we hold back a lithium supplement alongside prescribed lithium is that prescribed lithium is dosed against blood tests and supplemental lithium is not measured by them, and that argument is about lithium itself rather than about lamotrigine, so our curated interaction database records no interaction between lithium orotate and lamotrigine. Lamotrigine is cleared by a liver conjugation step, and lithium is an inorganic salt that the body does not metabolise at all, so the two travel separate routes. If you take lamotrigine it is still sensible to tell your prescriber about any supplement you start, because they are managing the whole picture.
Evidence: No direct study of this exact combination yet; the assessment rests on what is known about each of the two.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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