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Any expected or observed benefit of Lamictal in an individual patient with clinically important structural or functional heart disease must be carefully weighed against the risk for serious arrythmias and/or death for that patient. This replaces the summary from an October 2020 PI update that read, Avoid Lamictal in patients with underlying cardiac disorders or arrhythmias. Along with the March 31, 2021 PI update, FDA issued and broadly distributed a Drug Safety Communication about lamotrigine

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Low expression of ferroxidases is implicated in the iron retention in human atherosclerotic plaques