Indications & Dose: BIPOLAR DISORDER Prophylactic therapy PO Adult Initially 400mg/day in 2 divided doses, max 1600mg/dayunresponsive to lithium | EPILEPSY PO Adult Initially 100–200mg OD/BID, MD 0.8–1.2g/day in divided doses, max 1.6–2g/day Child Up to 1 yr: 100–200 mg, 1–5 yrs: 200–400mg, 5–10 yrs: 400–600mg, 10–15 yrs: 0.4–1g Elderly Reduce the initial dose | TRIGEMINAL NEURALGIA PO Adult Initially 200mg/day in 2 divided doses, MD 400-800mg/day in 2 divided doses, max 1200mg/day

Precautions: Avoid abrupt drug withdrawal, hepatic/renal impairment, cardiac disease, history of blood disorders, glaucoma

ADR: Serious: osteomalacia, CHF, SJS, TEN, hepatitis, ARF, thromboembolism, cholestatic jaundice, pulmonary hypersensitivity, arrhythmias, Others: Hyponatremia, drowsiness, dizziness, ataxia, diplopia, nausea, vomiting, anorexia, abdominal pain, diarrhea, constipation, alopecia, arthralgia, fever, proteinuria, paresthesia, photosensitivity, edema, depression

DDI: Serious Warfarin anticoagulant effects reduced, Oxybutynin/Dantrolene/Ritonavir/Valnoctamide causes drug toxicity, Levothyroxine causes hypothyroidism, Isoniazid causes toxicity, Teniposide clearance increased, Danazol doubles the drug levels and causes its toxicity, Allopurinol in high dose raises drug serum level, Cimetidine increases adverse effects by long term use of drug, Fluconazole/Dextropropoxyphene/Fluoxetine/Fluvoxamine/Influenza vaccines/Ketoconazole increases drug level, Erythromycin/Clarithromycin increases drug level and develops toxicity, Verapamil/Diltiazem increases drug level leads to toxicity, Lamotrigine increases levels and causes toxicity, Alcohol increases the drug metabolism, Lithium increases the risk of neurotoxicity, Statins level reduces, Clozapine levels are halved by drug, Ciclosporin/Alprazolam/Fluphenazine/Levetiracetam/Midazolam/Olanzapine/Pregabalin/TCAs/Topiramate/Vincristine levels are reduced, Nifedipine/Felodipine/Nimodipine levels are reduced by drug, Bupropion levels decreases but increases the levels of its active metabolite, Phenytoin levels may increase/decrease by drug, Vit D metabolism disturbance may leads to osteomalacia by long term use of drug, Haloperidol plasma levels are halved by drug, Mebendazole/Albendazole plasma levels reduced, Combined hormonal contraceptives reduces contraceptive efficacy, Phenobarbital reduces drug level and raise its active metabolite, Felbamate reduces drug levels but increases its active metabolite, Hydrochlorothiazide/Furosemide results in hyponatremia Others Valproic acid increases drug active metabolites

Diet: With food

Monitor: CBC, LFT, BUN, drug level,