Indications And Dose
Focal and secondary generalised tonic-clonic seizures | Primary generalised tonic-clonic seizures ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Initially 100–200 mg 1–2 times a day, increased in steps of 100–200 mg every 2 weeks; usual dose 0.8–1.2 g daily in divided doses; increased if necessary up to 1.6–2 g daily in divided doses ▶Elderly: Reduce initial dose ▶BY RECTUM ▶Adult: Up to 1 g daily in 4 divided doses for up to 7 days, for short-term use when oral therapy temporarily not possible Trigeminal neuralgia ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Initially 100 mg 1–2 times a day, some patients may require higher initial dose, increase gradually according to response; usual dose 200 mg 3–4 times a day, increased if necessary up to 1.6 g daily Prophylaxis of bipolar disorder unresponsive to lithium ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Initially 400 mg daily in divided doses, increased until symptoms controlled; usual dose 400–600 mg daily; maximum 1.6 g per day Adjunct in acute alcohol withdrawal ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Initially 800 mg daily in divided doses, then reduced to 200 mg daily for usual treatment duration of 7–10 days, dose to be reduced gradually over 5 days Diabetic neuropathy ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: Initially 100 mg 1–2 times a day, increased gradually according to response; usual dose 200 mg 3–4 times a day, increased if necessary up to 1.6 g daily Focal and generalised tonic-clonic seizures ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Child 1 month–11 years: Initially 5 mg/kg once daily, dose to be taken at night, alternatively initially 2.5 mg/kg twice daily, then increased in steps of 2.5–5 mg/kg every 3–7 days as required; maintenance 5 mg/kg 2–3 times a day, increased if necessary up to 20 mg/kg daily ▶Child 12–17 years: Initially 100–200 mg 1–2 times a day, then increased to 200–400 mg 2–3 times a day, increased if necessary up to 1.8 g daily, dose should be increased slowly DOSE EQUIVALENCE AND CONVERSION ▶Suppositories of 125 mg may be considered to be approximately equivalent in therapeutic effect to tablets of 100 mg but final adjustment should always depend on clinical response (plasma concentration monitoring recommended). CARBAGEN ® SR Focal and secondary generalised tonic-clonic seizures | Primary generalised tonic-clonic seizures Nervous system ▶BY MOUTH ▶Adult: Initially 100–400 mg daily in 1–2 divided doses, increased in steps of 100–200 mg every 2 weeks, dose should be increased slowly; usual dose 0.8–1.2 g daily in 1–2 divided doses, increased if necessary up to 1.6–2 g daily in 1–2 divided doses ▶Elderly: Reduce initial dose Trigeminal neuralgia ▶BY MOUTH ▶Adult: Initially 100–200 mg daily in 1–2 divided doses, some patients may require higher initial dose, increase gradually according to response; usual dose 600–800 mg daily in 1–2 divided doses, increased if necessary up to 1.6 g daily in 1–2 divided doses Prophylaxis of bipolar disorder unresponsive to lithium ▶BY MOUTH ▶Adult: Initially 400 mg daily in 1–2 divided doses, increased until symptoms controlled; usual dose 400–600 mg daily in 1–2 divided doses; maximum 1.6 g per day Focal and generalised tonic-clonic seizures | Prophylaxis of bipolar disorder ▶BY MOUTH ▶Child 5–11 years: Initially 5 mg/kg daily in 1–2 divided doses, then increased in steps of 2.5–5 mg/kg every 3–7 days as required, dose should be increased slowly; maintenance 10–15 mg/kg daily in 1–2 divided doses, increased if necessary up to 20 mg/kg daily in 1–2 divided doses ▶Child 12–17 years: Initially 100–400 mg daily in 1–2 divided doses, then increased to 400–1200 mg daily in 1–2 divided doses, increased if necessary up to 1.8 g daily in 1–2 divided doses, dose should be increased slowly TEGRETOL ® PROLONGED RELEASE Focal and secondary generalised tonic-clonic seizures | Primary generalised tonic-clonic seizures ▶BY MOUTH ▶Adult: Initially 100–400 mg daily in 2 divided doses, increased in steps of 100–200 mg every 2 weeks, dose should be increased slowly; usual dose 0.8–1.2 g daily in 2 divided doses, increased if necessary up to 1.6–2 g daily in 2 divided doses ▶Elderly: Reduce initial dose Focal and generalised tonic-clonic seizures | Prophylaxis of bipolar disorder ▶BY MOUTH ▶Child 5–11 years: Initially 5 mg/kg daily in 2 divided doses, then increased in steps of 2.5–5 mg/kg every 3–7 days as required; maintenance 10–15 mg/kg daily in 2 divided doses, increased if necessary up to 20 mg/kg daily in 2 divided doses ▶Child 12–17 years: Initially 100–400 mg daily in 2 divided doses, dose should be increased slowly; maintenance 400–1200 mg daily in 2 divided doses, increased if necessary up to 1.8 g daily in 2 divided doses Trigeminal neuralgia ▶BY MOUTH ▶Adult: Initially 100–200 mg daily in 2 divided doses, some patients may require higher initial dose. After initial dose, increase according to response; usual dose 600–800 mg daily in 2 divided doses, increased if necessary up to 1.6 g daily in 2 divided doses, dose continued → should be increased slowly Prophylaxis of bipolar disorder unresponsive to lithium ▶BY MOUTH ▶Adult: Initially 400 mg daily in 2 divided doses, increased until symptoms controlled; usual dose 400–600 mg daily in 2 divided doses; maximum 1.6 g per day Nervous system l UNLICENSED USE ▶In children Not licensed for use in trigeminal neuralgia or prophylaxis of bipolar disorder. ▶In adults Not licensed for use in acute alcohol withdrawal. Use in diabetic neuropathy is an unlicensed indication.
Source pages 349, 350