EpilepsyAdult 600 mg in 2 divided doses. May be increased by 200 mg every 3 days to 1-2 g daily (20-30 mg/kg daily) up to a max of 2.5 g/day. Childn 20-30 mg/kg/daily, may be increased to 40 mg/kg daily in severe cases. Combination w/ anticonvulsants (phenytoin, phenobarb & carbamazepine): Initiation therapy should be gradual to raise by 5-10 mg/kg/day. Bipolar Initially, 20 mg/kg/day. Max: 3,000 mg/day. Maintenance: 1,000-2,000 mg/day.
Should be taken with food: Swallow whole, do not chew/crush.
Contraindications
Hypersensitivity. Acute & chronic hepatitis, family history of severe hepatitis, drug-induced hepatitis, porphyria. Patients known to have mitochondrial disorders caused by mutations.
Confusion or convulsion; GI disturbances eg, nausea, gastric pain; hair loss, fine postural tremor; wt gain, amenorrhea, menstrual disturbances; dose-related rise in bleeding time, decrease fibrinogen; thrombocytopenia; isolated hyperammonaemia.
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