CNS: SUICIDAL THOUGHTS, confusional state, memory impairment, drowsiness, fatigue.
CV: edema.
Derm: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.
EENT: blurred vision, nystagmus, vision loss, tunnel vision.
Hemat: anemia.
Metab: weight gain.
MS: arthralgia.
Neuro: abnormal coordination, tremor, peripheral neuropathy.
Either tablets or powder for oral solution can be used for refractory complex partial seizures; only powder for oral solution should be used for IS.
Refractory Complex Partial Seizures
- PO (Adults and Children >16 yr): 500 mg twice daily initially, may be ↑ in 500 mg increments every 7 days depending on response up to 1500 mg twice daily.
- PO (Children 10–16 yr and >60 kg): 500 mg twice daily initially, may be ↑ in 500 mg increments every 7 days depending on response up to 1500 mg twice daily.
- PO (Children 10–16 yr and 25–60 kg): 250 mg twice daily initially, may be ↑ every 7 days depending on response up to 1000 mg twice daily.
Renal Impairment
- PO (Adults and Children
10 yr and 25 kg): CCr >50–80 mL/min — ↓dose by 25%; CCr >30–50 mL/min — ↓dose by 50%; CCr >10–30 mL/min — ↓dose by 75%.
Infantile Spasms
- PO (Children 1 mo–2 yr): 25 mg/kg twice daily initially, may be ↑ by 25-50 mg/kg/day increments every 3 days up to a maximum of 150 mg/kg/day (75 mg/kg twice daily); dosage adjustments are necessary for renal impairment.
Therapeutic Classification: anticonvulsants
Absorption: Completely absorbed following oral administration.
Distribution: Enters breast milk, remainder of distribution unknown.
Protein Binding: None.
Metabolism/Excretion: Minimal metabolism, mostly eliminated unchanged in urine.
Half-life: 7.5 hr.
(anticonvulsant effect)
†blood level.
†clinical benefit should be seen in 2–4 wk for IS or within 3 mo for complex partial seizures.