Indications And Dose
Monotherapy of generalised tonic-clonic seizures or focal seizures with or without secondary generalisation ▶BY MOUTH ▶Child 6–17 years: Initially 0.5–1 mg/kg once daily (max. per dose 25 mg) for 1 week, dose to be taken at night, then increased in steps of 250–500 micrograms/kg twice daily, dose to be increased by a maximum of 25 mg twice daily at intervals of 1–2 weeks; usual dose 50 mg twice daily (max. per dose 7.5 mg/kg twice daily), if child cannot tolerate titration regimens recommended above then smaller steps or longer interval between steps may be used; maximum 500 mg per day ▶Adult: Initially 25 mg once daily for 1 week, dose to be taken at night, then increased in steps of 25–50 mg every 1–2 weeks, dose to be taken in 2 divided doses; usual dose 100–200 mg daily in 2 divided doses, adjusted according to response, doses of 1 g daily have been used in refractory epilepsy; maximum 500 mg per day Adjunctive treatment of generalised tonic-clonic seizures or focal seizures with or without secondary generalisation| Adjunctive treatment for seizures associated with Lennox-Gastaut syndrome ▶BY MOUTH ▶Child 2–17 years: Initially 1–3 mg/kg once daily (max. per dose 25 mg) for 1 week, dose to be taken at night, then increased in steps of 0.5–1.5 mg/kg twice daily, dose to be increased by a maximum of 25 mg twice daily at intervals of 1–2 weeks; usual dose 2.5–4.5 mg/kg twice daily (max. per dose 7.5 mg/kg twice daily), if child cannot tolerate recommended titration regimen then smaller steps or longer interval between steps may be used; maximum 400 mg per day ▶Adult: Initially 25–50 mg once daily for 1 week, dose to be taken at night, then increased in steps of 25–50 mg every 1–2 weeks, dose to be taken in 2 divided doses; usual dose 200–400 mg daily in 2 divided doses; maximum 400 mg per day Migraine prophylaxis ▶BY MOUTH ▶Adult: Initially 25 mg once daily for 1 week, dose to be taken at night, then increased in steps of 25 mg every week; usual dose 50–100 mg daily in 2 divided doses; maximum 200 mg per day
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