Adult & adolescent from 16 yr Monotherapy Initially 250 mg bid, then should be increased to 500 mg bid after 2 wk. Dose can be further increased by 250 mg bid every 2 wk depending upon the clinical response. Max: 1,500 mg bid.
Adult (≥18 yr) & adolescents (12-17 yr) weighing ≥50 kg Add-on therapy Initially 500 mg bid & can be increased up to 1,500 mg bid. Dose changes can be made in 500 mg bid increases or decreases every 2-4 wk.
Childn (4-11 yr) & adolescents (12-17 yr) weighing <50 kg Add-on therapy Initially 10 mg/kg bid. Dose can be increased up to 30 mg/kg bid depending upon the clinical response & tolerability. Dose changes should not exceed increases or decreases of 10 mg/kg bid every 2 wk,
15 kg 150 mg bid. Max: 450 mg bid,
20 kg 200 mg bid. Max: 600 mg bid,
25 kg 250 mg bid. Max: 750 mg bid,
from 50 kg 500 mg bid. Max: 1,500 mg bid (adult dose).
Mild renal impairment (CrCl 50-79 mL/min/1.73 m2) 500-1,000 mg bid.
Moderate renal impairment (CrCl 30-49 mL/min/1.73 m2) 250-750 mg bid.
Severe renal impairment (CrCl <30 mL/min/1.73 m2) 250-500 mg bid.
ESRD patients undergoing dialysis Loading dose: 750 mg on the 1st day of treatment. 500-1,000 mg once daily. Following dialysis, 250-500 mg supplemental dose is recommended.
Hepatic impairment (CrCl <60 mL/min/1.73 m2) ½ daily maintenance dose.