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Epilepsy: Adults: Initial oral dose is 100 mg to 200 mg once or twice daily gradually increased at weekly intervals by increments of 200 mg to a usual maintenance dose of 0.8 to 1.2 g daily in 2 to 4 divided doses; up to 1.6 g or more daily may occasionally be necessary.
Children: The usual oral dosage in children is 10 to 20 mg per kilogram body-weight daily and suggested daily doses for children are: up to 1 year of age, 100 to 200 mg; 1 to 5 years, 200 to 400 mg; 5 to 10 years, 400 to 600 mg; 10 to 15 years, 600 mg to 1 g.
Oral doses are divided and usually given 2 to 4 times daily. A twice daily regimen may be associated with improved compliance but may produce widely fluctuating plasma-carbamazepine concentrations leading to intermittent side effects.
However, twice daily administration may be suitable for patients receiving carbamazepine as monotherapy, and without peak-related side-effects.
Also, slow-release formulations can minimize fluctuations in plasma concentration and may allow twice-daily administration.
The initial dose of carbamazepine in the treatment of trigeminal neuralgia is 100 mg once or twice daily increased gradually; the usual maintenance dose is 400 to 800 mg daily in 2 to 4 divided doses but up to 1.6 g daily may be required. When pain relief has been obtained, attempts should be made to reduce and ultimately discontinue the therapy, until another attack occurs. Carbamazepine is usually given in daily divided doses of 400 to 600 mg for the prophylaxis of bipolar disorder.
