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Hi, this is Dr Ansari, welcome to JA.
Yes can you tell me if facial pain is like in this area
you are mixing two things if your facial pain is like this area middle of the face then it may be Trigeminal Neuralgia
Vaccine has its side effects, fever, headache, joint pains if you have a migraine that will accentuate
yep can be
You can continue Lamictal, If any episode of headache and facial pain occur take tab Aleve (Naproxen)500 mg once or twice a day for 3 days if needed. your MRI brain is clear and no venous thromboses as you told. You may go ahead with the second dose of AZ.
You have to start low and progress slowly.
It is safe to take and has no drug drug interactions.
sorry you are not taking valproate
For patient not on any other medication the scheme is simple
1st week Lamictal 25 mg once daily in morning
2nd week 25 mg moring and night
3rd week 50 in morning and 25 in night
4th week 50 in morning and 50 in night.
The dose advised for you is a short course but why stop after 21 days. Did he tell you?
For Migraine Aura, you have to continue for six months. If it is controlled then observe 2 months after that reduce to 25 mg twice daily. and maintain the same.
If you want a safer regime. you can take 25 mg Lamictal once a day for one month. you can increase this dose by 25 mg every month not more than 300 mg, For most patients, dosages in the range of 75 and 150 mg were sufficient to achieve a consistent response. Once aura stopped then maintain 2 months on the dose it stopped . after 2 months reduce 25 mg every month till the dose remained 50 mg once a day and maintain this dose.
Everything has risk, and that's why we advise you to start low and progress slowly so as to avoid side effects. The final choice is yours. If you will choose others may also have the risk of side effects that may be a little different. So when your doctor has advised he also want you to follow up with him.