DOSAGE AND ADMINISTRATION
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 patients. A
low initial daily dosage with gradual increase is advised. As soon as adequate
control is achieved, the dosage may be reduced very gradually to the minimum
effective level. The Carbatrol capsules may be opened and the beads sprinkled
over food, such as a teaspoon of applesauce or other similar food products if
this method of administration is preferred. Carbatrol capsules or their contents
should not be crushed or chewed. Carbatrol can be taken with or without
meals.
Carbatrol is an extended-release formulation for twice a day administration.
When converting patients from immediate release carbamazepine to Carbatrol
extended-release capsules, the same total daily mg dose of carbamazepine should
be administered.
Epilepsy (see INDICATIONS AND USAGE)
Adults and children over 12 years of age.
Initial: 200 mg twice daily. Increase at weekly intervals by adding up to
200 mg/day until the optimal response is obtained. Dosage generally should not
exceed 1000 mg per day in children 12-15 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. Maintenance: Adjust dosage to the minimum
effective level, usually 800-1200 mg daily.
Children under 12 years of age: Children taking total
daily dosages of immediate-release carbamazepine of 400 mg or greater may be
converted to the same total daily dosage of Carbatrol extended-release capsules,
using a twice daily regimen. 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 Carbatrol
for use at doses above 35 mg/kg/24 hours can be made.
Combination Therapy: Carbatrol 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 Pregnancy Category D).
Trigeminal Neuralgia (see INDICATIONS AND USAGE)
Initial: On the first day, start with one
200 mg capsule. This daily dose may be increased by up to 200 mg/day 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 400-800 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.
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