Initially 5 mg tid, increased to 10 mg tid for 3 days then in similar increments & intervals up to 20 mg tid. Childn >10 yr Initially 2.5 mg qid increased every 3 days. Max daily dose: 2.5 mg/kg; 6-10 yr 30-60 mg; 2-6 yr 20-30 mg; 12 mth-2 yr 10-20 mg.
Patients w/ history or active PUD; severe psychiatric disorders, epilepsy or convulsive disorders. Renal & resp impairment. DM, cerebrovascular disease. Patients using spasticity to maintain posture or to increase function. Hypertonic bladder sphincters. Avoid abrupt w/drawal. May impair ability to drive or operate machinery. Elderly.
Alcohol & other CNS depressants may exacerbate CNS effects. Lithium may cause severe aggravation of hyperkinetic symptoms. Increased weakness w/ TCAs & hypotensive effect w/ antihypertensive therapy. Ibuprofen & other drugs that produce renal insufficiency may reduce excretion leading to toxicity.
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