Partial-Onset Seizures

• PO IV (Adults ): Monotherapy (immediate-release PO or IV): 100 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 150–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily for 1 wk; may then ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 150–200 mg twice daily. Monotherapy (extended-release PO)200 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 300–400 mg once daily; Adjunctive therapy (immediate-release PO or IV): 50 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily for 1 wk; may then ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily. Adjunctive therapy (extended-release PO): 100 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 200–400 mg once daily.
• PO IV (Children ≥1 mo and ≥50 kg): Monotherapy (immediate-release PO or IV): 50 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 150–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily for 1 wk; may then ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 150–200 mg twice daily. Monotherapy (extended-release PO): 100 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 300–400 mg once daily. Adjunctive therapy (immediate-release PO or IV): 50 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily for 1 wk; may then ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily. Adjunctive therapy (extended-release PO): 100 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 200–400 mg once daily.
• PO IV (Children ≥1 mo and 30–<50 kg): Monotherapy or adjunctive therapy (immediate-release PO or IV): 1 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 2–4 mg/kg twice daily; may also initiate therapy with 4 mg/kg single loading dose followed 12 hr later by 2 mg/kg twice daily for 1 wk; may then ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 2–4 mg/kg twice daily.
• PO IV (Children ≥1 mo and 6–<30 kg): Monotherapy or adjunctive therapy (immediate-release PO or IV): 1 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3–6 mg/kg twice daily; may also initiate therapy with 4.5 mg/kg single loading dose followed 12 hr later by 3 mg/kg twice daily for 1 wk; may then ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3–6 mg/kg twice daily.
• PO (Children ≥1 mo and <6 kg): Monotherapy or adjunctive therapy (immediate-release PO or IV): 1 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3.75–7.5 mg/kg twice daily; may also initiate therapy with 3.75 mg/kg twice daily for 1 wk; may then ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3.75–7.5 mg/kg twice daily.
• IV (Children ≥1 mo and <6 kg): Monotherapy or adjunctive therapy (immediate-release PO or IV): 0.66 mg/kg 3 times daily; may ↑ weekly by 2 mg/kg/day in 3 divided doses up to a maintenance dose of 2.5–5 mg/kg 3 times daily; may also initiate therapy with 2.5 mg/kg 3 times daily for 1 wk; may then ↑ weekly by 2 mg/kg/day in 3 divided doses up to a maintenance dose of 2.5–5 mg/kg 3 times daily.

Renal Impairment

• PO IV (Adults and Children ≥1 mo): CCr ≤30 mL: Monotherapy or adjunctive therapy (immediate-release PO or IV): ↓ maximum dose by 25%. Monotherapy or adjunctive therapy (extended-release PO): Not to exceed maximum dose of 300 mg once daily.

Hepatic Impairment

• PO IV (Adults and Children ≥1 mo): Mild or moderate hepatic impairment: Monotherapy or adjunctive therapy (immediate-release PO or IV): ↓ maximum dose by 25%. Monotherapy or adjunctive therapy (extended-release PO): Not to exceed dose of 300 mg once daily.

Primary Generalized Tonic-Clonic Seizures

• PO IV (Adults ): Adjunctive therapy (immediate-release PO or IV): 50 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily.Adjunctive therapy (extended-release PO): 100 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 200–400 mg once daily.
• PO IV (Children ≥4 yr and ≥50 kg): Adjunctive therapy (immediate-release PO or IV): 50 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily; may also initiate therapy with 200-mg single loading dose followed 12 hr later by 100 mg twice daily; may ↑ weekly by 100 mg/day in 2 divided doses up to a maintenance dose of 100–200 mg twice daily. Adjunctive therapy (extended-release PO): 100 mg once daily; may ↑ weekly by 100 mg once daily up to a maintenance dose of 200–400 mg once daily.
• PO IV (Children ≥4 yr and 30–<50 kg): Adjunctive therapy (immediate-release PO or IV): 1 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 2–4 mg/kg twice daily; may also initiate therapy with 4 mg/kg single loading dose followed 12 hr later by 2 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 2–4 mg/kg twice daily.
• PO IV (Children ≥4 yr and 11–<30 kg): Adjunctive therapy (immediate-release PO or IV): 1 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3–6 mg/kg twice daily; may also initiate therapy with 4.5 mg/kg single loading dose followed 12 hr later by 3 mg/kg twice daily; may ↑ weekly by 2 mg/kg/day in 2 divided doses up to a maintenance dose of 3–6 mg/kg twice daily.

Renal Impairment

• PO IV (Adults and Children ≥4 yr): CCr ≤30 mL/min: Adjunctive therapy (immediate-release PO or IV): ↓ maximum dose by 25%. Adjunctive therapy (extended-release PO): Not to exceed dose of 300 mg once daily.

Hepatic Impairment

• PO IV (Adults and Children ≥4 yr): Mild or moderate hepatic impairment: Adjunctive therapy (immediate-release PO or IV): ↓ maximum dose by 25%. Adjunctive therapy (extended-release PO): Not to exceed dose of 300 mg once daily.