Initially 0.375 mg/day in 3 divided doses, should not increase more frequently than every 5-7 days.
Ascending dosage schedule Wk 1: 0.125 mg tid. Wk 2: 0.25 mg tid. Wk 3: 0.5 mg tid. Wk 4: 0.75 mg tid. Wk 5: 1 mg tid. Wk 6: 1.25 mg tid. Wk 7: 1.5 mg tid.
Maintenance 1.5-4.5 mg/day in equally divided doses tid.
Patient w/ renal impairment CrCl >50 mL/min Starting dose: 0.125 mg tid. Max: 1.5 mg tid.
CrCl 30-50 mL/min Starting dose: 0.125 mg bid. Max: 0.75 mg tid.
CrCl 15-30 mL/min Starting dose: 0.125 mg once daily. Max: 1.5 mg once daily.
Discontinuation of treatment May be tapered off at a rate of 0.75 mg/day then by 0.375 mg/day if the dose has been reduced to 0.75 mg.