Daily dose is administered in 2 equally divided doses. Adult & adolescent ≥16 yr Initially 500 mg twice daily, may be increased up to 1,500 mg twice daily. Dose changes can be made in 500 mg twice daily increments or decrements 2-4 wkly. Dose adjustment: Renal impairment: Normal CrCl ≥80 mL/min 500-1,500 mg twice daily; mild CrCl 50-79 mL/min 500-1,000 mg twice daily; moderate CrCl 30-49 mL/min 250-750 mg twice daily; severe CrCl <30 mL/min 250-500 mg twice daily; ESRD patients undergoing dialysis 500-1,000 mg once daily. Loading dose: 750 mg on 1st day of treatment. Supplemental dose of 250-500 mg is recommended following dialysis.
When discontinuing treatment, w/draw gradually. Perform CBC in patients experiencing important weakness, pyrexia, recurrent infections, or coagulation disorders. Monitor for signs of depression &/or suicidal ideation & behaviours; developing psychiatric signs suggesting important mood &/or personality changes. May rarely exacerbate seizure frequency/severity. Patients w/ QTc-interval prolongation, concomitantly treated w/ drugs affecting the QTc-interval, or w/ relevant pre-existing cardiac disease or electrolyte disturbances. Minor or moderate influence on the ability to drive & use machines. Acute kidney injury. Renal & severe hepatic impairment. Women of childbearing potential. Lowest effective dose is recommended during pregnancy. Not recommended during lactation. Elderly patients (≥65 yr) w/ compromised renal function. Childn & adolescents <6 yr.
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