DOSAGE AND ADMINISTRATION
(See table.)
Monitoring of blood levels has increased the efficacy and safety of anticonvulsants (see PRECAUTIONS, Laboratory Tests). Dosage should be adjusted to the needs of the individual patient. A low initial daily dosage with a gradual increase is advised. As soon as adequate control is achieved, the dosage may be reduced very gradually to the minimum effective level. Medication should be taken with meals.
Conversion of patients from oral carbamazepine tablets to carbamazepine suspension: Patients should be converted by administering the same number of mg per day in smaller, more frequent doses (i.e., b.i.d. tablets to t.i.d. suspension).
Epilepsy
(See INDICATIONS AND USAGE.)
Adults and Children Over 12 Years of Age
Initial: 200 mg b.i.d. Increase at weekly intervals by adding up to 200 mg/day using a t.i.d. or q.i.d. regimen until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily in children 12 to 15 years of age, and 1200 mg daily in patients above 15 years of age. Doses up to 1600 mg daily have been used in adults in rare instances. Maintenance: Adjust dosage to the minimum effective level, usually 800 to 1200 mg daily.
Children 6 to 12 Years of Age
Initial: 100 mg b.i.d. Increase at weekly intervals by adding up to 100 mg/day using a t.i.d. or q.i.d. regimen until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily. Maintenance: Adjust dosage to the minimum effective level, usually 400 to 800 mg daily.
Children Under 6 Years of Age
Initial: 10 to 20 mg/kg/day b.i.d. or t.i.d. Increase weekly to achieve optimal clinical response administered t.i.d. or q.i.d. Maintenance: Ordinarily, optimal clinical response is achieved at daily doses below 35 mg/kg. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the therapeutic range. No recommendation regarding the safety of carbamazepine for use at doses above 35 mg/kg/24 hours can be made.
Combination Therapy
Carbamazepine may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy, the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased (see PRECAUTIONS, Drug Interactions, and Usage in Pregnancy, Teratogenic Effects, Pregnancy category D).
Trigeminal Neuralgia
(See INDICATIONS AND USAGE.)
Initial: On the first day, 100 mg b.i.d. for a total daily dose of 200 mg. This daily dose may be increased by up to 200 mg/day using increments of 100 mg every 12 hours only as needed to achieve freedom from pain. Do not exceed 1200 mg daily. Maintenance: Control of pain can be maintained in most patients with 400 to 800 mg daily. However, some patients may be maintained on as little as 200 mg daily, while others may require as much as 1200 mg daily. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or even to discontinue the drug.
Dosage Information |
*Tablet = Chewable or conventional tablets
|
| Initial Dose | Subsequent Dose | Maximum Daily Dose |
| Indication | Tablet* |
| Epilepsy | | | |
| Under 6 yr | 10 to 20 mg/kg/day b.i.d. or t.i.d. | Increase weekly to achieve optimal clinical response, t.i.d. or q.i.d. | 35 mg/kg/24 hr (see D O SAGE AND ADMINISTRATION) |
| 6 to 12 yr | 100 mg b.i.d. (200 mg/day) | Add up to 100 mg/day at weekly intervals, t.i.d. or q.i.d. | 1000 mg/24 hr |
| Over 12 yr | 200 mg b.i.d. (400 mg/day) | Add up to 200 mg/day at weekly intervals, t.i.d. or q.i.d. | 1000 mg/24 hr (12 to 15 yr) 1200 mg/24 hr (> 15 yr) 1600 mg/24 hr (adults, in rare instances) |
| Trig eminal Neur algia | 100 mg b.i.d. (200 mg/day) | Add up to 200 mg/day in increments of 100 mg every 12 hr | 1200 mg/24 hr |
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