Indications And Dose
Monotherapy of focal seizures | Monotherapy of primary and secondary generalised tonic-clonic seizures | Monotherapy of seizures associated with Lennox- Gastaut syndrome ▶BY MOUTH ▶Child 12–17 years: Initially 25 mg once daily for 14 days, then increased to 50 mg once daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses; increased if necessary up to 500 mg daily, dose titration should be repeated if restarting after interval of more than 5 days ▶Adult: Initially 25 mg once daily for 14 days, then increased to 50 mg once daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses; increased if necessary up to 500 mg daily, dose titration should be repeated if restarting after interval of more than 5 days Adjunctive therapy of focal seizures with valproate | Adjunctive therapy of primary and secondary generalised tonic-clonic seizures with valproate | Adjunctive therapy of seizures associated with Lennox- Gastaut syndrome with valproate ▶BY MOUTH ▶Child 2–11 years (body-weight up to 13 kg): Initially 2 mg once daily on alternate days for first 14 days, then 300 micrograms/kg once daily for further 14 days, then increased in steps of up to 300 micrograms/kg every 7–14 days; maintenance 1–5 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum 200 mg per day ▶Child 2–11 years (body-weight 13 kg and above): Initially 150 micrograms/kg once daily for 14 days, then 300 micrograms/kg once daily for further 14 days, then increased in steps of up to 300 micrograms/kg every 7–14 days; maintenance 1–5 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum 200 mg per day ▶Child 12–17 years: Initially 25 mg once daily on alternate days for 14 days, then 25 mg once daily for further 14 days, then increased in steps of up to 50 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days ▶Adult: Initially 25 mg once daily on alternate days for 14 days, then 25 mg once daily for further 14 days, then increased in steps of up to 50 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days Adjunctive therapy of focal seizures (with enzyme inducing drugs) without valproate | Adjunctive therapy of primary and secondary generalised tonic-clonic seizures (with enzyme inducing drugs) without valproate | Adjunctive therapy of seizures associated with Lennox- Gastaut syndromes (with enzyme inducing drugs) without valproate ▶BY MOUTH ▶Child 2–11 years: Initially 300 micrograms/kg twice daily for 14 days, then 600 micrograms/kg twice daily for further 14 days, then increased in steps of up to 1.2 mg/kg every 7–14 days; maintenance 5–15 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum 400 mg per day ▶Child 12–17 years: Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 200–400 mg daily in 2 divided doses, increased if necessary up to 700 mg daily, dose titration should be repeated if restarting after interval of more than 5 days ▶Adult: Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 200–400 mg daily in 2 divided doses, increased if necessary up to 700 mg daily, dose titration should be repeated if restarting after interval of more than 5 days Adjunctive therapy of focal seizures (without enzyme inducing drugs) without valproate | Adjunctive therapy of primary and secondary generalised tonic-clonic seizures (without enzyme inducing drugs) without valproate | Adjunctive therapy of seizures associated with Lennox- Gastaut syndromes (without enzyme inducing drugs) without valproate ▶BY MOUTH ▶Child 2–11 years: Initially 300 micrograms/kg daily in 1–2 divided doses for 14 days, then 600 micrograms/kg daily in 1–2 divided doses for further 14 days, then increased in steps of up to 600 micrograms/kg every 7–14 days; maintenance 1–10 mg/kg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days; maximum 200 mg per day ▶Child 12–17 years: Initially 25 mg once daily for 14 days, then increased to 50 mg once daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days ▶Adult: Initially 25 mg once daily for 14 days, then increased to 50 mg once daily for further 14 days, then increased in steps of up to 100 mg every 7–14 days; maintenance 100–200 mg daily in 1–2 divided doses, dose titration should be repeated if restarting after interval of more than 5 days Monotherapy or adjunctive therapy of bipolar disorder (without enzyme inducing drugs) without valproate ▶BY MOUTH ▶Adult: Initially 25 mg once daily for 14 days, then 50 mg daily in 1–2 divided doses for further 14 days, then 100 mg daily in 1–2 divided doses for further 7 days; maintenance 200 mg daily in 1–2 divided doses, patients stabilised on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens— consult product literature, dose titration should be repeated if restarting after interval of more than 5 days; maximum 400 mg per day Adjunctive therapy of bipolar disorder with valproate ▶BY MOUTH ▶Adult: Initially 25 mg once daily on alternate days for 14 days, then 25 mg once daily for further 14 days, then 50 mg daily in 1–2 divided doses for further 7 days; maintenance 100 mg daily in 1–2 divided doses, patients stabilised on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens— consult product literature, dose titration should be repeated if restarting after interval of more than 5 days; maximum 200 mg per day Adjunctive therapy of bipolar disorder (with enzyme inducing drugs) without valproate ▶BY MOUTH ▶Adult: Initially 50 mg once daily for 14 days, then 50 mg twice daily for further 14 days, then increased to 100 mg twice daily for further 7 days, then increased to 150 mg twice daily for further 7 days; maintenance 200 mg twice daily, patients stabilised on lamotrigine for bipolar disorder may require dose adjustments if other drugs are added to or withdrawn from their treatment regimens—consult product literature, dose titration should be repeated if restarting after interval of more than 5 days
Source pages 356, 357