Monotherapy Adult & adolescent >16 yr 250 mg bid. To be increased to initial dose of 500 mg bid after 2 wk. May be further increased by 250 mg bid every 2 wk depending upon clinical response. Max: 1,500 mg bid.
Add-on therapy Adult ≥18 yr & adolescent 12-17 yr weighing ≥50 kg Initially 500 mg bid. May be increased up to 1,500 mg bid. Change dose in 500 mg bid increases or decreases every 2-4 wk.
Adolescent 12-17 yr & childn 6-11 yr weighing <50 kg Use the lowest effective dose. Initially 250 mg bid in childn or adolescent of 25 kg. Max: 750 mg bid.
Renal impairment Adult & adolescent weighing >50 kg CrCl >80 mL/min/1.73 m2 500-1,500 mg bid,
50-79 mL/min/1.73 m2 500-1,000 mg bid,
30-49 mL/min/1.73 m2 250-750 mg bid,
<30 mL/min/1.73 m2 250-500 mg bid;
ESRD patients undergoing dialysis 500-1,000 mg once daily, w/ a 750-mg loading dose on the 1st day of treatment then a 250- to 500-mg supplemental dose following dialysis.
Childn & adolescent weighing <50 kg CrCl >80 mL/min/1.73 m2 10-30 mg/kg bid,
50-79 mL/min/1.73 m2 10-20 mg/kg bid,
30-49 mL/min/1.73 m2 5-15 mg/kg,
<30 mL/min/1.73 m2 5- 10 mg/kg bid;
ESRD patients undergoing dialysis 10-20 mg/kg once daily, w/ a 15-mg/kg loading dose on the 1st day of treatment then a 5- to 10-mg/kg supplemental dose following dialysis.
Severe hepatic impairment 50% reduction of daily maintenance dose when CrCl is <60 mL/min/1.73 m
2.
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