Indications & Dose: GENERALIZED TONIC–CLONIC SEIZURES Adjuvant therapy PO/IV Adult Initially 500mg BID, adjusted in steps of 500mg BID q2-4 wk max 1.5g BID Child 12-18 yr (<50 kg): Initially 10mg/kg BID, adjust in steps not exceeding 10mg/kg BID q2wk max 30mg/kg BID | MYOCLONIC SEIZURES Adjuvant therapy PO/IV Adult Initially 500mg BID, adjusted in steps of 500mg BID q2-4 wk max 1.5g BID Child 12-18 yr (<50 kg): Initially 10mg/kg BID, adjust in steps not exceeding 10mg/kg BID q2wk max 30mg/kg BID | PARTIAL SEIZURES WITH/ WITHOUT SECONDARY GENERALIZATION Adjuvant therapy PO/IV Adult Initially 500mg BID, adjusted in steps of 500mg BID q2-4 wk max 1.5g BID Child 4-18 yr (<50 kg): Initially 10mg/kg BID, adjust in steps not exceeding 10mg/kg BID q2wk max 30mg/kg BID | Mono therapy PO/IV Adult Initially 250mg BID, increase to 250mg BID q2wk or according to response max 1.5g BID Child >16 yr: Same as adult dose

Precautions: Hepatic/renal impairment, avoid abrupt withdrawal

ADR: Serious: Thrombocytopenia, pancreatitis, hepatic dysfunction, seizures, Others: insomnia, headache, anxiety, impaired attention, aggression, paresthesia, pancytopenia, alopecia, rash, ataxia, nausea, vomiting, dyspepsia, diarrhea, abdominal pain, anorexia, cough, drowsiness

DDI: Serious Phenytoin modestly raises drug level, Carbamazepine toxicity occurred Others Probenecid increases levels of inactive metabolite of drug

Diet: With/without food

Monitor: Suicidal thoughts, depression, behavioral changes