Adult Initially 300 mg tds, may be increased to max 1,800 mg/day. Doses up to 3,600 mg/day have been well tolerated. Daily maintenance dose: Should be given in 3 equally divided doses w/ max interval of 12 hr between doses. Patient w/ renal impairment, CrCl >30-59 mL/min 400-1,400 mg/day in 2 divided doses administered bd, CrCl >15-29 mL/min 200-700 mg once daily, CrCl 15 mL/min 100-300 mg once daily. Patient on hemodialysis 125-350 mg/day post-hemodialysis supplemental dose administered after each 4 hr of hemodialysis.
Not effective in the treatment of absence seizures; caution in patients who have mixed seizure disorders that include absence seizures. Possibility of increased seizure frequency w/ abrupt w/drawal. Associated w/ dizziness & somnolence; CNS depression as well as serious cases of resp depression. May result in life-threatening resp depression when concomitantly used w/ opioids. May cause psychomotor impairment. Can cause anaphylaxis. Discontinue in case of hypersensitivity reactions or signs & symptoms suggestive of Stevens-Johnson syndrome, erythema multiforme, drug rash w/ eosinophilia & systemic symptoms (DRESS). Monitor patients for signs of suicidal ideation & behaviour. Patients w/ history of drug abuse. For urinary protein determination, sulfosalicylic acid precipitation procedure is recommended. Patients w/ renal impairment. May cause fetal harm. Pregnancy & lactation. Ped patients <18 yr. Elderly >65 yr.
Not recommended w/ co-administration of Al- & Mg-based antacids. Additive effect on impairment of cognitive & gross motor function w/ opioids, benzodiazepines, alcohol. Resp failure, coma, death w/ other CNS depressants, including in patients w/ substance use disorders.
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