Neuropathic pain Initially 150 mg daily as 2 or 3 divided doses, may be increased to 300 mg daily after 3-7 days interval. Max: 600 mg daily after additional 7-day interval. GAD 150-600 mg daily as 2 or 3 divided doses. Initially 150 mg daily, may be increased to 300 mg daily after 1 wk, then to 450 mg daily following additional wk. Max: 600 mg daily after additional wk. Epilepsy Initially 150 mg daily, may be increased to 300 mg daily after 1 wk. Max: 600 mg daily after additional wk. Fibromyalgia 300-450 mg daily in 2 divided doses. Initially 75 mg bd, may be increased to 150 mg bd w/in 1 wk or may be further increased to 225 mg bd. Max: 600 mg daily after additional wk.
Discontinue use if hypersensitivity reactions eg, angioedema occur. Increased risk of suicidal thoughts or behaviour. CHF; dizziness, somnolence, loss of consciousness, confusion & mental impairment; loss of or blurred vision or other changes of visual acuity; compromised resp function, resp or neurological disease; reduced lower GIT function eg, intestinal obstruction, paralytic ileus, constipation; encephalopathy. Monitor for history of substance abuse & signs of misuse, abuse or dependence eg, development of tolerance, dose escalation, drug-seeking behavior. Diabetic patients. Avoid abrupt w/drawal; taper-off gradually over at least 1 wk. Concomitant use w/ anti-spasticity agents; CNS depressants, opioids. Not to be taken by patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive & use machines. Renal failure. Women of childbearing potential must use effective contraception. Not to be used during pregnancy. Lactation. Not recommended in childn <12 yr & adolescents 12-17 yr. Elderly >65 yr.
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