Adult Initially 5 mg daily, may increase over the 1st 4 wk of treatment reaching the recommended maintenance dose. Dose titration: Wk 1 (day 1-7): 5 mg daily for 7 days; wk 2 (day 8-14): 10 mg daily for 7 days; wk 3 (day 15-21): 15 mg daily for 7 days; from wk 4 onwards: 20 mg once daily. Maintenance: 20 mg daily. Elderly >65 yr 20 daily. Moderate renal impairment (CrCl 30-49 mL/min) 10 mg daily, may increase up to 20 mg daily if dose is tolerated after at least 7 days of treatment. Severe renal impairment (CrCl 5-29 mL/min) 10 daily.
Patients w/ epilepsy, former history of convulsions, or those w/ predisposing factors for epilepsy; recent MI, uncompensated CHF (NYHA III-IV), or uncontrolled HTN. Avoid concomitant use of NMDA-antagonists eg, amantadine, ketamine or dextromethorphan. Careful monitoring of urine pH. Galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption. Close monitoring of prothrombin time or INR w/ concomitant use of oral anticoagulants. Minor or moderate influence on the ability to drive & use machines. Not recommended in patients w/ severe hepatic impairment. Pregnancy. Do not use during lactation. Not recommended in childn <18 yr.
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