Monotherapy Adult & adolescent from 16 yr Initially 250 mg bid, may be increased to 500 mg bid after 2 wk, then further increased by 250 mg bid every 2 wk depending upon clinical response. Max: 1500 mg bid.
Add on therapy Adult 18 yr & adolescent 12-17 yr weighing ≥50 kg Initially 500 mg bid on 1st day of treatment, may be increased up to 1,500 mg bid. Dose changes can be made in 500 mg bid increases or decreases every 2-4 wk.
Childn 4-11 yr & adolescent 12-17 yr weighing≥50 kg Adult dose,
<50 kg 10 mg/kg bid, may be increased up to 30 mg/kg bid. Dose changes: Not to exceed increases or decreases of 10 mg/kg bid every 2 wk.
Renal impairment Adult & adolescent weighing >50 kg, CrCl ≥80 mL/min/1.73 m2 500-1,500 bid,
50-79 mL/min/1.73 m2 500-1,000 bid,
30-49 mL/min/1.73 m2 250-750 bid,
<30 mL/min/1.73 m2 250-500 bid.
ESRD patient undergoing dialysis 500-1,000 once daily, following dialysis administer 250-500 mg as supplemental dose.
Childn & adolescent weighing <50 kg, CrCl ≥80 mL/min/1.73 m2 10-30 mg/kg bid,
50-79 mL/min/1.73 m2 10-20 mg/kg bid,
30-49 mL/min/1.73 m2 5-15 mg/kg bid,
<30 mL/min/1.73 m2 5-10 mg/kg bid.
ESRD patient undergoing dialysis 10-20 mg/kg once daily; 15 mg/kg as loading dose on 1st day of treatment, following dialysis administer 5-10 mg/kg as supplemental dose.
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