Rivotril Dosage/Direction for Use

Standard dosage: The dosage of Rivotril must be individually adjusted according to the patient's clinical response, tolerance of the drug, and the patient's age. To ensure optimum dosage adjustment, infants should be given the drops and children the 0.5 mg tablets. The single break-mark 0.5 mg tablets facilitate the administration of lower daily doses to adults in the initial stages of treatment.
As a general rule, Rivotril is given as low-dose, single-drug therapy in new, non-therapy-resistant cases.
A single oral dose of Rivotril begins to take effect within 30-60 minutes and remains effective for 6-8 hours in children and 8-12 hours in adults.
To avoid adverse reactions at the beginning of therapy, it is essential to increase the daily dose progressively until the maintenance dose suited to the individual patient has been reached.
The initial dose for infants and children up to the age of 10 years (or up to 30 kg bodyweight) is 0.01-0.03 mg/kg daily. For children over 10 years (or over 30 kg) and for adults, the recommended initial dose is 1-2 mg daily.
The maintenance dose for infants and children up to the age of 10 years (or up to 30 kg bodyweight) is 0.05-0.1 mg/kg daily. For children 10-16 years (or over 30 kg), a dose of 1.5-3 mg daily, and for adults, a dose of 2-4 mg daily is recommended.
Once the maintenance dose level has been reached, the daily amount may be given in a single dose in the evening. Should several doses be necessary, the largest should be taken in the evening. The maintenance dose level is best attained after 1-3 weeks of treatment. To ensure optimum dosage adjustment, infants should be given the drops and children the 0.5 mg tablets.
The single break-mark 0.5 mg tablets facilitate the administration of lower daily doses to adults in the initial stages of treatment.
The maximum therapeutic dose for adults is 20 mg daily.
Before adding Rivotril to an existing anticonvulsant regimen, it should be considered that the use of multiple anticonvulsants may result in an increase of undesired effects.
Special dosage instructions: Rivotril can be administered concurrently with one or several other antiepileptic agents, in which case the dosage of each drug must be adjusted to achieve the optimum effect.
As with all antiepileptic agents, treatment with Rivotril must not be stopped abruptly, but must be reduced in a stepwise fashion (see Adverse Reactions).