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Anticonvulsants (Adult dosing)

brivaracetam- BRIVIACT® --®
carbamazepine - Tegretol ® clonazepam Klonopin ®
clobazam - ONFI diazepam - Valium®
eslicarbazepine acet- APTIOM® ethosuximide - Zarontin®
ezogabine - POTIGA™ felbamate - Felbatol®
fosphenytoin - Cerebyx ® gabapentin (Neurontin ®)
lacosamide -VIMPAT® levetiracetam - Keppra®
lamotrigine - Lamictal® lorazepam - Ativan®
oxcarbazepine - Trileptal® perampanel - FYCOMPA®new icon
phenobarbital phenytoin - Dilantin®
pregabalin  -Lyrica® primidone - Mysoline®
rufinamide -BANZEL® tiagabine - Gabitril ®
topiramate - Topamax ®, QUDEXY ® XR valproic acid: Depacon ® Depakene ® Depakote ®
vigabatrin -Sabril® zonisamide - Zonegran ®
-- --
Please see package insert for additional information and possible updates. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.    [  Read the disclaimer    |   <<Back    |    New drug index   ]

brivaracetam- BRIVIACT®  top of page

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Drug UPDATES
BRIVIACT®- brivaracetam tablet, film coated
BRIVIACT®- brivaracetam solution
BRIVIACT®- brivaracetam injection, suspension

[Drug information  /  PDF]  
Dosing:  Click (+) next to Dosage and Administration section (drug info link)

Initial U.S. Approval:  2016

Mechanism of Action:
The precise mechanism by which BRIVIACT exerts its anticonvulsant activity is not known. Brivaracetam displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the anticonvulsant effect.

INDICATIONS AND USAGE:
BRIVIACT is indicated as adjunctive therapy in the treatment of partial-onset seizures in patients 16 years of age and older with epilepsy.


DOSAGE AND ADMINISTRATION
Dosage Information
When initiating treatment, gradual dose escalation is not required. The recommended starting dosage is 50 mg twice daily (100 mg per day). Based on individual patient tolerability and therapeutic response, the dosage may be adjusted down to 25 mg twice daily (50 mg per day) or up to 100 mg twice daily (200 mg per day) [see Clinical Studies (14)].

BRIVIACT injection may be used when oral administration is temporarily not feasible. BRIVIACT injection should be administered at the same dosage and same frequency as BRIVIACT tablets and oral solution.

The clinical study experience with BRIVIACT injection is limited to 4 consecutive days of treatment.

2.2 Administration Instructions for BRIVIACT Tablets and BRIVIACT Oral Solution

BRIVIACT can be initiated with either intravenous or oral administration.
BRIVIACT tablets and oral solution may be taken with or without food.

BRIVIACT Tablets
BRIVIACT tablets should be swallowed whole with liquid. BRIVIACT tablets should not be chewed or crushed.

BRIVIACT Oral Solution
A calibrated measuring device is recommended to measure and deliver the prescribed dose accurately. A household teaspoon or tablespoon is not an adequate measuring device.

When using BRIVIACT oral solution, no dilution is necessary. BRIVIACT oral solution may also be administered using a nasogastric tube or gastrostomy tube.

Discard any unused BRIVIACT oral solution remaining after 5 months of first opening the bottle.

2.3 Preparation and Administration Instructions for BRIVIACT Injection
BRIVIACT injection is for intravenous use only.

Preparation
BRIVIACT injection can be administered intravenously without further dilution or may be mixed with diluents listed below.


Diluents
0.9% Sodium Chloride injection, USP
Lactated Ringer's injection
5% Dextrose injection, USP

Administration
BRIVIACT injection should be administered intravenously over 2 to 15 minutes.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Product with particulate matter or discoloration should not be used. BRIVIACT injection is for single dose only.

Storage and Stability
The diluted solution should not be stored for more than 4 hours at room temperature and may be stored in polyvinyl chloride (PVC) bags. Discard any unused portion of the BRIVIACT injection vial contents.

HOW SUPPLIED:
Tablets
10 mg: white to off white, round, film-coated, and debossed with "u10" on one side.
25 mg: grey, oval, film-coated, and debossed with "u25" on one side.
50 mg: yellow, oval, film-coated, and debossed with "u50" on one side.
75 mg: purple, oval, film-coated, and debossed with "u75" on one side.
100 mg: green-grey, oval, film-coated, and debossed with "u100" on one side.

Oral Solution
10 mg/mL: slightly viscous, clear, colorless to yellowish, raspberry-flavored liquid.

Injection
50 mg in 5 mL in one single-dose vial. It is a clear, colorless, sterile solution.

carbamazepine - Tegretol ®: top of page

New IV formulation below.

INDICATIONS AND USAGE
 Epilepsy: Carbamazepine tablets are indicated for use as an anticonvulsant drug. Evidence supporting efficacy of carbamazepine as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types:

1. Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvement than those with other types.

2. Generalized tonic-clonic seizures (grand mal).

3. Mixed seizure patterns which include the above, or other partial or generalized seizures. Absence seizures (petit mal) do not appear to be controlled by carbamazepine (see PRECAUTIONS, General).

Trigeminal Neuralgia: Carbamazepine tablets are indicated in the treatment of the pain associated with true trigeminal neuralgia.  Beneficial results have also been reported in glossopharyngeal neuralgia.   This drug is not a simple analgesic and should not be used for the relief of trivial aches or pains.

DOSAGE AND ADMINISTRATION
Monitoring of blood levels has increased the efficacy and safety of anticonvulsants. Dosage should be adjusted to the needs of the individual patient. A low initial daily dosage with a gradual increase is advised. As soon as adequate control is achieved, the dosage may be reduced very gradually to the minimum effective level. Tablets should be taken with meals.

Conversion of patients from oral carbamazepine tablets to carbamazepine suspension: Patients should be converted by administering the same number of mg per day in smaller, more frequent doses (i.e., b.i.d. tablets to t.i.d. suspension).

Epilepsy:

Adults And Children Over 12 Years Of Age - Initial: 200 mg b.i.d. Increase at weekly intervals by adding up to 200 mg/day using a t.i.d. or q.i.d. regimen until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily in children 12 to 15 years of age, and 1200 mg daily in patients above 15 years of age. Doses up to 1600 mg daily have been used in adults in rare instances.
Maintenance: Adjust dosage to the minimum effective level, usually 800 to 1200 mg daily.
---------

Children 6 to 12 years of age - Initial: 100 mg b.i.d. Increase at weekly intervals by adding up to 100 mg/day using a t.i.d. or q.i.d. regimen until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily.   Maintenance: Adjust dosage to the minimum effective level, usually 400 to 800 mg daily.
---------
Children Under 6 Years Of Age - Initial: 10 to 20 mg/kg/day b.i.d. or t.i.d. Increase weekly to achieve optimal clinical response administered t.i.d. or q.i.d.      Maintenance: Ordinarily, optimal clinical response is achieved at daily doses below 35 mg/kg. If satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the therapeutic range. No recommendation regarding the safety of carbamazepine for use at doses above 35 mg/kg/24 hours can be made.
---------
Combination Therapy: Carbamazepine may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy, the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased.

Trigeminal Neuralgia:
Initial: On the first day, 100 mg b.i.d., for a total daily dose of 200 mg. This daily dose may be increased by up to 200 mg/day using increments of 100 mg every 12 hours for tablets, only as needed to achieve freedom from pain. Do not exceed 1200 mg daily.

Maintenance: Control of pain can be maintained in most patients with 400 to 800 mg daily. However, some patients may be maintained on as little as 200 mg daily, while others may require as much as 1200 mg daily. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or even to discontinue the drug.


Carbamazepine Dosage Information
  Initial
Dose
Subsequent
Dose
Maximum Daily Dose
Indication      
Epilepsy Under 6 yr

10 to 20 mg/kg/day
b.i.d. or t.i.d.


Increase weekly to achieve
optimal clinical response,
t.i.d. or q.i.d.


35 mg/kg/24 hr
6 to 12 yr 100 mg b.i.d.”
(200 mg/day)
Add up to 100 mg/day
at weekly intervals,
t.i.d. or q.i.d.
1000 mg/24 hr
Over 12 yr 200 mg b.i.d.
(400 mg/day)
Add up to 200 mg/day
at weekly intervals,
t.i.d. or q.i.d.
1000 mg/24 hr (12 to 15 yr)
1200 mg/24 hr (>15 yr)
1600 mg/24 hr (adults, in
rare instances)
Trigeminal
Neuralgia

100 mg b.i.d. (200 mg/day)

Add up to 200 mg/day
in increments of 100 mg every 12 hr

1200 mg/24


DOSAGE FORMS AND STRENGTHS
Extended release cap: 100 mg, 200 mg, 300 mg.
Oral suspension: 100 mg/5 ml (10 ml, 450 ml).
Tablet: 200 mg.  Chewable tab: 100 mg.  ER Tab: 100 mg, 200 mg, 400 mg.


---
Drug UPDATESCARNEXIV™ (carbamazepine) injection, for intravenous use
[Drug information  /  PDF]     REVIEW PACKAGE INSERT FOR POSSIBLE UPDATES
PACKAGE INSERT -Dosing:  Click (+) next to Dosage and Administration section (drug info link)

BOXED WARNING
:   [Review package insert]
WARNING: SERIOUS DERMATOLOGIC REACTIONS and APLASTIC ANEMIA AND AGRANULOCYTOSIS

Serious Dermatologic Reactions and HLA-B*1502 Allele
Serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), have occurred in patients treated with carbamazepine. There is a strong association between the risk of developing SJS/TEN and the presence of HLA-B*1502, an inherited allelic variant of the HLA-B gene that is found almost exclusively in patients with Asian ancestry. Avoid use of CARNEXIV in patients testing positive for the allele unless the benefit clearly outweighs the risk. Discontinue CARNEXIV if you suspect that the patient is having a serious dermatologic reaction [see Warnings and Precautions (5.1)].

Aplastic Anemia and Agranulocytosis
Aplastic anemia and agranulocytosis can occur during treatment with CARNEXIV. Obtain a complete blood count (CBC) before beginning treatment with CARNEXIV, and monitor CBC periodically. Consider discontinuing CARNEXIV if significant bone marrow depression develops

Initial U.S. Approval:  2016   [Revised: 10/2016]

Mechanism of Action: The mechanism by which carbamazepine exerts its anticonvulsant activity is unknown. The principal metabolite of carbamazepine, carbamazepine-10,11-epoxide, has demonstrated anticonvulsant activity in in vivo animal models of seizures. However, its contribution to the therapeutic effect of carbamazepine is unknown.

INDICATIONS AND USAGE:
CARNEXIV is indicated as replacement therapy for oral carbamazepine formulations, when oral administration is temporarily not feasible, in adults with the following seizure types (1):

Partial seizures with complex symptomatology
Generalized tonic-clonic seizures
Mixed seizure patterns which include the above, or other partial or generalized seizures


DOSAGE AND ADMINISTRATION:
CARNEXIV is a replacement therapy for oral carbamazepine. Carbamazepine treatment should generally be initiated with an oral carbamazepine formulation.

The total daily dose of CARNEXIV is 70% of the total daily oral carbamazepine dose from which patients are being switched (see Table 1). The total daily dose of CARNEXIV should be equally divided in four 30-minute infusions, separated by 6 hours. Patients should be switched back to oral carbamazepine administration at their previous total daily oral dose and frequency of administration as soon as clinically appropriate. The use of CARNEXIV for periods of more than 7 days has not been studied.

Table 1. Determination of Total Daily Dose for CARNEXIV Infusion

 Total Daily Oral Carbamazepine Dose (mg/day)

 

Corresponding Total Daily Dose of CARNEXIV

(mg/day)

Dose of CARNEXIV

to be administered every 6 hours (mg)

400 

280 

70

600 

420 

105

800 

560 

140

1,000 

700 

175

1,200 

840 

210

1,400 

980 

245

1,600 

1,120 

280


Administration Information

CARNEXIV is for intravenous use only and must be diluted in a compatible diluent prior to infusion.
Using Table 2 as a guide, prepare the solution for each infusion by transferring the single dose volume of CARNEXIV to 100 mL of diluent solution (0.9% sodium chloride, lactated Ringer's solution, or 5% dextrose) and mixing gently.
Before administration, the prepared solution for infusion may be stored for a maximum of 4 hours at 20°C to 25°C (68°F to 77°F) or a maximum of 24 hours if refrigerated at 2°C to 8°C (36°F to 46°F).

Parenteral drug products should be inspected visually for particulate matter, cloudiness, or discoloration prior to administration, whenever solution and container permit. If any of these are present, discard the solution.

Administer each infusion intravenously over 30 minutes.

CARNEXIV injection vials are for single-dose only. Discard any unused portion.
Table 2. CARNEXIV Dose to Volume and Infusion

CARNEXIV Single Dose (mg/every 6 hours)

CARNEXIV
Single Dose Volume
(Vials Required)

  Diluent Volume

  Infusion Duration

Dose Frequency

70

7 mL (1)

 

 

 

100 mL

 

 

 

 

 

 

30 min

 

 

 

Every 6 hours

105

10.5 mL (1)

140

14 mL (1)

175

17.5 mL (1)

210

21 mL (2)

245

24.5 mL (2)

280

28 mL (2)


Renal Function Monitoring
Patients with renal impairment may be at greater risk for an adverse effect of CARNEXIV on renal function, and should have close monitoring of renal function during treatment with CARNEXIV. CARNEXIV should generally not be used in patients with moderate or severe renal impairment.

Serum Level Monitoring

Monitor serum carbamazepine concentrations in conditions in which alterations in carbamazepine metabolism can occur. This includes patients who have hepatic impairment and patients on drugs that either induce or inhibit carbamazepine metabolism.

Laboratory Testing Prior to Carbamazepine Initiation
Prior to initial treatment with carbamazepine, test patients with ancestry in genetically at-risk populations for the presence of the HLA-B*1502 allele. The high resolution genotype test is positive if one or two HLA-B*1502 alleles are present. Avoid use of CARNEXIV in patients testing positive for the allele, unless the benefit clearly outweighs the risk [see PACKAGE INSERT Boxed Warning and Warnings and Precautions (5.1)].

Complete pretreatment blood counts, including platelets and possibly reticulocytes and serum iron, should be obtained as a baseline. If a patient in the course of treatment exhibits low or decreased white blood cell or platelet counts, the patient should be monitored closely. Discontinuation of CARNEXIV should be considered if any evidence of significant bone marrow depression develops [see PACKAGE INSERT Warnings and Precautions (5.2)].

Baseline and periodic evaluations of liver function, particularly in patients with a history of liver disease, must be performed during treatment with carbamazepine because liver damage may occur. Discontinue CARNEXIV in cases of aggravated liver dysfunction or active liver disease [see PACKAGE INSERT Warnings and Precautions (5.10)].


HOW SUPPLIED:
CARNEXIV injection contains 200 mg/20 mL (10 mg/mL) carbamazepine as a clear, colorless, sterile solution in a single dose vial.

clonazepam  - Klonopin®: top of page

INDICATIONS AND USAGE
Seizure Disorders: Clonazepam is useful alone or as an adjunct in the treatment of the Lennox-Gastaut syndrome (petit mal variant), akinetic and myoclonic seizures. In patients with absence seizures (petit mal) who have failed to respond to succinimides, clonazepam may be useful.
In some studies, up to 30% of patients have shown a loss of anticonvulsant activity, often within three months of administration. In some cases, dosage adjustment may re-establish efficacy.

Panic Disorder: Clonazepam is indicated for the treatment of panic disorder, with or without agoraphobia, as defined in DSM-IV. Panic disorder is characterized by the occurrence of unexpected panic attacks and associated concern about having additional attacks, worry about the implications or consequences of the attacks, and/or a significant change in behavior related to the attacks.
 

DOSAGE AND ADMINISTRATION
Start 0.5 mg orally three times daily.  Maximum: 20 mg/day. 

DOSAGE FORMS AND STRENGTHS
 [Supplied: 0.5,1, 2mg tabs]

diazepam - Valium®: top of page

DOSAGE AND ADMINISTRATION
Dosage should be individualized for maximum beneficial effect. While the usual daily dosages given below will meet the needs of most patients, there will be some who may require higher doses. In such cases dosage should be increased cautiously to avoid adverse effects.

Oral:
ADULTS: USUAL DAILY DOSE
Management of Anxiety Disorders and Relief of Symptoms of Anxiety Depending upon severity of symptoms - 2 mg to 10 mg, 2 to 4 times daily
Symptomatic Relief in Acute Alcohol Withdrawal 10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg, 3 or 4 times daily as needed.
Adjunctively for Relief of Skeletal Muscle Spasm 2 mg to 10 mg, 3 or 4 times daily
Adjunctively in Convulsive Disorders 2 mg to 10 mg, 2 to 4 times daily
Geriatric Patients, or in the presence of debilitating disease 2 mg to 2.5 mg, 1 or 2 times daily initially; increase gradually as needed and tolerated.
PEDIATRIC PATIENTS:
Because of varied responses to CNS-acting drugs, initiate therapy with lowest dose and increase as required. Not for use in pediatric patients under 6 months. 1 mg to 2.5 mg, 3 or 4 times daily initially; increase gradually as needed and tolerated.


Parenteral:
Dosage should be individualized for maximum beneficial effect. The usual recommended dose in older children and adults ranges from 2 mg to 20 mg I.M. or I.V., depending on the indication and its severity. In some conditions, e.g., tetanus, larger doses may be required. (See dosage for specific indications.) In acute conditions the injection may be repeated within one hour although an interval of 3 to 4 hours is usually satisfactory. Lower doses (usually 2 mg to 5 mg) and slow increase in dosage should be used for elderly or debilitated patients and when other sedative drugs are administered.

For dosage in infants above the age of 30 days and children, see the specific indications below. When intravenous use is indicated, facilities for respiratory assistance should be readily available.

Intramuscular: Diazepam Injection, USP should be injected deeply into the muscle.

Intravenous use: (See package insert for WARNINGS, particularly for use in children.) The solution should be injected slowly, taking at least one minute for each 5 mg (1 mL) given. Do not use small veins, such as those on the dorsum of the hand or wrist. Extreme care should be taken to avoid intra-arterial administration or extravasation.

Do not mix or dilute diazepam with other solutions or drugs in syringe or infusion flask. If it is not feasible to administer diazepam directly I.V., it may be injected slowly through the infusion tubing as close as possible to the vein insertion.

Once the acute symptomatology has been properly controlled with diazepam injection, the patient may be placed on oral therapy with diazepam if further treatment is required.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. NOTE: Solution may appear colorless to light yellow.

      (I.V. administration should be made slowly)

USUAL ADULT DOSAGE

DOSAGE RANGE IN CHILDREN

Moderate Anxiety Disorders and Symptoms of Anxiety

2 mg to 5 mg, I.M. or I.V. Repeat in 3 to 4 hours, if necessary.

 

Severe Anxiety Disorders and Symptoms of Anxiety

5 mg to 10 mg, I.M. or I.V. Repeat in 3 to 4 hours, if necessary.

 

Acute Alcohol Withdrawal: As an aid in symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis.

10 mg, I.M. or I.V. initially, then 5 mg to 10 mg in 3 to 4 hours, if necessary.

 

 

Endoscopic Procedures: Adjunctively, if apprehension, anxiety or acute stress reactions are present prior to endoscopic procedures. Dosage of narcotics should be reduced by at least a third and in some cases may be omitted. See Precautions for peroral procedures.

Titrate I.V. dosage to desired sedative response, such as slurring of speech, with slow administration immediately prior to the procedure. Generally 10 mg or less is adequate, but up to 20 mg I.V. may be given, particularly when concomitant narcotics are omitted. If I.V. cannot be used, 5 mg to 10 mg I.M. approximately 30 minutes prior to the procedure.

 

Muscle Spasm: Associated with local pathology, cerebral palsy, athetosis, stiff-man syndrome or tetanus.

5 mg to 10 mg, I.M. or I.V. initially, then 5 mg to 10 mg in 3  to 4 hours, if necessary. For tetanus, larger doses may be required.

 

For tetanus in infants over 30 days of age, 1 mg to 2 mg I.M. or I.V., slowly, repeated every 3   to 4 hours as necessary. In children 5 years or older, 5 mg to 10 mg repeated every 3 to 4 hours may be required to control tetanus spasms. Respiratory assistance should be available.

Status Epilepticus and Severe Recurrent Convulsive Seizures: In the convulsing patient, the I.V. route is by far preferred. This injection should be administered slowly. However, if I.V. administration is impossible, the I.M. route may be used.

5 mg to 10 mg initially (I.V. preferred). This injection may be repeated if necessary at 10 to 15  minute intervals up to a maximum dose of 30 mg.

If necessary, therapy with diazepam may be repeated in 2 to 4 hours; however, residual active metabolites may persist, and readministration should be made with this consideration.

Extreme caution must be exercised with individuals with chronic lung disease or unstable cardiovascular status.

Infants over 30 days of age and children under 5 years, 0.2 mg to 0.5 mg slowly every 2 to 5 minutes up to a maximum of 5 mg (I.V. preferred). Children 5 years or older, 1 mg every 2 to 5 minutes up to a maximum of 10 mg (slow I.V. administration preferred). Repeat in 2 to 4 hours if necessary. EEG monitoring of the seizure may be helpful.

 

Preoperative Medication: To relieve anxiety and tension. (If atropine, scopolamine or other premedications are desired, they must be administered in separate syringes.)

10 mg, I.M. (preferred route), before surgery.

 

 

Cardioversion: To relieve anxiety and tension and to reduce recall of procedure.

5 mg to 15 mg, I.V., within 5 to 10 minutes prior to the procedure.

 


DOSAGE FORMS AND STRENGTHS
Tablets: 2mg , 5 mg, 10 mg
Diazepam Injection, 5 mg/mL [2ml, 10 ml]
Diazepam Oral Solution, 5 mg per 5 mL (Orange-colored, wintergreen-spice flavored solution)

Diazepam IntensolTM Oral Solution (Concentrate), 5 mg per mL
NDC 0054-3185-44: Bottle of 30 mL with calibrated dropper [graduations of 0.2 mL (1 mg), 0.4 mL (2 mg), 0.6 mL (3 mg), 0.8 mL (4 mg), and 1 mL (5 mg) on the dropper].

ethosuximide - Zarontin®: top of page

INDICATIONS AND USAGE
Zarontin is indicated for the control of absence (petit mal) epilepsy.

DOSAGE AND ADMINISTRATION
Zarontin is administered by the oral route.

The initial dose for patients 3 to 6 years of age is one capsule (250 mg) per day;
for patients 6 years of age and older, 2 capsules (500 mg) per day. The dose thereafter must be individualized according to the patient's response. Dosage should be increased by small increments. One useful method is to increase the daily dose by 250 mg every four to seven days until control is achieved with minimal side effects.

Dosages exceeding 1.5 g daily, in divided doses, should be administered only under the strictest supervision of the physician.

The optimal dose for most pediatric patients is 20 mg/kg/day. This dose has given average plasma levels within the accepted therapeutic range of 40 to 100 mcg/mL. Subsequent dose schedules can be based on effectiveness and plasma level determinations.

Zarontin may be administered in combination with other anticonvulsants when other forms of epilepsy coexist with absence (petit mal). The optimal dose for most pediatric patients is 20 mg/kg/day.

DOSAGE FORMS AND STRENGTHS
Capsule: 250 mg.

Ethosuximide Syrup, USP 250 mg/5 mL is supplied as: NDC 46672-641-16 - 16 fl oz bottles. Each 5 mL of Syrup contains 250 mg ethosuximide in a raspberry flavored base.

Solution: NDC 0071-2418-23-1 pint bottles. Each 5 mL of oral solution contains 250 mg ethosuximide in a raspberry flavored base.

ezogabine - POTIGA™: top of page

POTIGA is a potassium channel opener indicated as adjunctive treatment of partial-onset seizures in patients aged 18 years and older.

Local monograph

felbamate - Felbatol®: top of page

WARNINGS
See package insert for Boxed Warning regarding aplastic anemia and hepatic failure.
Antiepileptic drugs should not be suddenly discontinued because of the possibility of increasing seizure frequency.

Felbatol® is not indicated as a first line antiepileptic treatment. Felbatol® is recommended for use only in those patients who respond inadequately to alternative treatments and whose epilepsy is so severe that a substantial risk of aplastic anemia and/or liver failure is deemed acceptable in light of the benefits conferred by its use.

If these criteria are met and the patient has been fully advised of the risk, and has provided written acknowledgement, Felbatol® can be considered for either monotherapy or adjunctive therapy in the treatment of partial seizures, with and without generalization, in adults with epilepsy and as adjunctive therapy in the treatment of partial and generalized seizures associated with Lennox-Gastaut syndrome in children.

DOSAGE AND ADMINISTRATION
Felbatol® (felbamate) has been studied as monotherapy and adjunctive therapy in adults and as adjunctive therapy in children with seizures associated with Lennox-Gastaut syndrome. As Felbatol® is added to or substituted for existing AEDs, it is strongly recommended to reduce the dosage of those AEDs in the range of 20-33% to minimize side effects.

Dosage Adjustment in the Renally Impaired: Felbamate should be used with caution in patients with renal dysfunction. In the renally impaired, starting and maintenance doses should be reduced by one-half. Adjunctive therapy with medications which affect felbamate plasma concentrations, especially AEDs, may warrant further reductions in felbamate daily doses in patients with renal dysfunction.

Adults (14 years of age and over)
The majority of patients received 3600 mg/day in clinical trials evaluating its use as both monotherapy and adjunctive therapy.

Monotherapy: (Initial therapy) Felbatol® (felbamate) has not been systematically evaluated as initial monotherapy. Initiate Felbatol® at 1200 mg/day in divided doses three or four times daily. The prescriber is advised to titrate previously untreated patients under close clinical supervision, increasing the dosage in 600-mg increments every 2 weeks to 2400 mg/day based on clinical response and thereafter to 3600 mg/day if clinically indicated.

Conversion to Monotherapy: Initiate Felbatol® at 1200 mg/day in divided doses three or four times daily. Reduce the dosage of concomitant AEDs by one-third at initiation of Felbatol® therapy. At week 2, increase the Felbatol® dosage to 2400 mg/day while reducing the dosage of other AEDs up to an additional one-third of their original dosage. At week 3, increase the Felbatol® dosage up to 3600 mg/day and continue to reduce the dosage of other AEDs as clinically indicated.

Adjunctive Therapy: Felbatol® should be added at 1200 mg/day in divided doses three or four times daily while reducing present AEDs by 20% in order to control plasma concentrations of concurrent phenytoin, valproic acid, phenobarbital, and carbamazepine and its metabolites. Further reductions of the concomitant AEDs dosage may be necessary to minimize side effects due to drug interactions. Increase the dosage of Felbatol® by 1200 mg/day increments at weekly intervals to 3600 mg/day. Most side effects seen during Felbatol® adjunctive therapy resolve as the dosage of concomitant AEDs is decreased.
Dosage Table (adults)
Dosage reduction of concomitant AEDs WEEK 1
REDUCE original dose by
20-33%*
WEEK 2
REDUCE original dose by
up to an additional 1/3*
WEEK 3
REDUCE as
clinically
indicated
Felbatol®
Dosage
1200 mg/day Initial dose 2400 mg/day
Therapeutic dosage range
3600 mg/day
Therapeutic dosage range
While the above Felbatol® conversion guidelines may result in a Felbatol® 3600 mg/day dose within 3 weeks, in some patients titration to a 3600 mg/day Felbatol® dose has been achieved in as little as 3 days with appropriate adjustment of other AEDs.

Children with Lennox-Gastaut Syndrome (Ages 2-14 years)
Adjunctive Therapy: Felbatol® should be added at 15 mg/kg/day in divided doses three or four times daily while reducing present AEDs by 20% in order to control plasma levels of concurrent phenytoin, valproic acid, phenobarbital, and carbamazepine and its metabolites. Further reductions of the concomitant AEDs dosage may be necessary to minimize side effects due to drug interactions. Increase the dosage of Felbatol® by 15 mg/kg/day increments at weekly intervals to 45 mg/kg/day. Most side effects seen during Felbatol® adjunctive therapy resolve as the dosage of concomitant AEDs is decreased.

DOSAGE FORMS AND STRENGTHS
Supplied: [400 , 600 mg  tablets]

fosphenytoin - Cerebyx ®: top of page

INDICATIONS AND USAGE
Fosphenytoin sodium injection is indicated for short-term parenteral administration when other means of phenytoin administration are unavailable, inappropriate or deemed less advantageous. The safety and effectiveness of fosphenytoin sodium injection in this use has not been systematically evaluated for more than 5 days.

Fosphenytoin sodium injection can be used for the control of generalized convulsive status epilepticus and prevention and treatment of seizures occurring during neurosurgery. It can also be substituted, short-term, for oral phenytoin.

DOSAGE AND ADMINISTRATION
The dose, concentration in dosing solutions, and infusion rate of IV fosphenytoin sodium injection is expressed as phenytoin sodium equivalents (PE) to avoid the need to perform molecular weight-based adjustments when converting between fosphenytoin and phenytoin sodium doses. Fosphenytoin sodium injection should always be prescribed and dispensed in phenytoin sodium equivalent units (PE). Fosphenytoin sodium injection has important differences in administration from those for parenteral phenytoin sodium (see below).

Products with particulate matter or discoloration should not be used. Prior to IV infusion, dilute fosphenytoin sodium injection in 5% dextrose or 0.9% saline solution for injection to a concentration ranging from 1.5 to 25 mg PE/mL.

Status Epilepticus
>The loading dose of fosphenytoin sodium injection is 15 to 20 mg PE/kg administered at 100 to 150 mg PE/min.
>Because of the risk of hypotension, fosphenytoin should be administered no faster than 150 mg PE/min. Continuous monitoring of the electrocardiogram, blood pressure, and respiratory function is essential and the patient should be observed throughout the period where maximal serum phenytoin concentrations occur, approximately 10 to 20 minutes after the end of fosphenytoin sodium injection infusions.
>Because the full antiepileptic effect of phenytoin, whether given as fosphenytoin sodium injection or parenteral phenytoin, is not immediate, other measures, including concomitant administration of an IV benzodiazepine, will usually be necessary for the control of status epilepticus.
>The loading dose should be followed by maintenance doses of fosphenytoin sodium injection or phenytoin either orally or parenterally.

If administration of fosphenytoin sodium injection does not terminate seizures, the use of other anticonvulsants and other appropriate measures should be considered.

IM fosphenytoin sodium injection should not be used in the treatment of status epilepticus because therapeutic phenytoin concentrations may not be reached as quickly as with IV administration. If IV access is impossible, loading doses of fosphenytoin sodium injection have been given by the IM route for other indications.

No Emergent Loading and Maintenance Dosing
The loading dose of fosphenytoin sodium injection is 10 to 20 mg PE/kg given IV or IM. The rate of administration for IV fosphenytoin sodium injection should be no greater than 150 mg PE/min. Continuous monitoring of the electrocardiogram, blood pressure, and respiratory function is essential and the patient should be observed throughout the period where maximal serum phenytoin concentrations occur, approximately 10 to 20 minutes after the end of fosphenytoin sodium injection infusions.

The initial daily maintenance dose of fosphenytoin sodium injection is 4 to 6 mg PE/kg/day.

IM or IV Substitution for Oral Phenytoin Therapy
Fosphenytoin sodium injection can be substituted for oral phenytoin sodium therapy at the same total daily dose.

Phenytoin sodium capsules are approximately 90% bioavailable by the oral route. Phenytoin, supplied as fosphenytoin sodium injection, is 100% bioavailable by both the IM and IV routes. For this reason, plasma phenytoin concentrations may increase modestly when IM or IV fosphenytoin sodium injection is substituted for oral phenytoin sodium therapy.

The rate of administration for IV fosphenytoin sodium injection should be no greater than 150 mg PE/min.

In controlled trials, IM fosphenytoin sodium injection was administered as a single daily dose utilizing either 1 or 2 injection sites. Some patients may require more frequent dosing.

Dosing in Special Populations
Patients with Renal or Hepatic Disease: Due to an increased fraction of unbound phenytoin in patients with renal or hepatic disease, or in those with hypoalbuminemia, the interpretation of total phenytoin plasma concentrations should be made with caution. Unbound phenytoin concentrations may be more useful in these patient populations. After IV fosphenytoin sodium injection administration to patients with renal and/or hepatic disease, or in those with hypoalbuminemia, fosphenytoin clearance to phenytoin may be increased without a similar increase in phenytoin clearance. This has the potential to increase the frequency and severity of adverse events.

Elderly Patients: Age does not have a significant impact on the pharmacokinetics of fosphenytoin following fosphenytoin sodium injection administration. Phenytoin clearance is decreased slightly in elderly patients and lower or less frequent dosing may be required.

Pediatric: The safety of fosphenytoin sodium injection in pediatric patients has not been established.


DOSAGE FORMS AND STRENGTHS
Fosphenytoin Sodium Injection 50 mg/ml [2 ml , 10 ml vials]

gabapentin (Neurontin ®): top of page

DOSAGE AND ADMINISTRATION
-General dosing: Start 300mg at bedtime. Increase over few days to 300 to 600mg orally three times daily. Maximum: 3600mg/day.

Dosing (Adults): 
Anticonvulsant:
Oral:  Initial: 300 mg 3 times/day, if necessary the dose may be increased up to 1800 mg/day.    Maintenance: 900-1800 mg/day administered in 3 divided doses; doses of up to 2400 mg/day have been tolerated in long-term clinical studies; up to 3600 mg/day has been tolerated in short-term studies. 

Postherpetic neuralgia:
Day 1: 300 mg, Day 2: 300 mg twice daily, Day 3: 300 mg 3 times/day; dose may be titrated as needed for pain relief (range: 1800-3600 mg/day, daily doses >1800 mg do not generally show greater benefit)

Renal dosing:   
Crcl > 60 ml/minute: 300-1200 mg 3 times/day.
Crcl >30-59 ml/minute:200-700 mg twice/day.
Crcl >15-29 ml/minute: 200-700 mg/day.  
Crcl 15 ml/minute: 100-300mg/day.
Crcl <15 ml/minute: Reduce daily dose in proportion to creatinine clearance.

DOSAGE FORMS AND STRENGTHS
Supplied: Capsule: 100 mg, 300 mg, 400 mg.  Oral Solution: 250 mg/5 ml (480 ml).  Tablet: 100 mg, 300 mg, 400 mg.

lacosamide -VIMPAT®: top of page

INDICATIONS AND USAGE
Partial-Onset Seizures
VIMPAT (lacosamide) tablets and oral solution are indicated as adjunctive therapy in the treatment of partial-onset seizures in patients with epilepsy aged 17 years and older.

VIMPAT (lacosamide) injection for intravenous use is indicated as adjunctive therapy in the treatment of partial-onset seizures in patients with epilepsy aged 17 years and older when oral administration is temporarily not feasible.

USE IN SPECIFIC POPULATIONS
To enroll in the UCB AED Pregnancy Registry call 1-888-537-7734 (toll free).To enroll in the North American Antiepileptic Drug Pregnancy Registry call 1-888-233-2334 (toll free).

Renal impairment: Dose adjustment is recommended for patients with severe renal impairment (creatinine clearance leq 30 mL/min). Dose supplementation should be considered following hemodialysis.

Hepatic impairment: Dose adjustment is recommended for patients with mild or moderate hepatic impairment. Use in severe hepatic impairment patients is not recommended. Patients with co-existing hepatic and renal impairment should be monitored closely during dose titration.

DOSAGE AND ADMINISTRATION------------------------
VIMPAT may be taken with or without food.

When using VIMPAT oral solution, it is recommended that a calibrated measuring device be obtained and used. A household teaspoon or tablespoon is not an adequate measuring device. Healthcare providers should recommend a device that can measure and deliver the prescribed dose accurately, and provide instructions for measuring the dosage.

Partial-Onset Seizures
VIMPAT can be initiated with either oral or intravenous administration. The initial dose should be 50 mg twice daily (100 mg per day). VIMPAT can be increased at weekly intervals by 100 mg/day given as two divided doses up to the recommended maintenance dose of 200 to 400 mg/day, based on individual patient response and tolerability. In clinical trials, the 600 mg daily dose was not more effective than the 400 mg daily dose, and was associated with a substantially higher rate of adverse reactions.

Switching from Oral to Intravenous Dosing
When switching from oral VIMPAT, the initial total daily intravenous dosage of VIMPAT should be equivalent to the total daily dosage and frequency of oral VIMPAT and should be infused intravenously over a period of 30 to 60 minutes. There is experience with twice daily intravenous infusion for up to 5 days.

Switching from Intravenous to Oral Dosing
At the end of the intravenous treatment period, the patient may be switched to VIMPAT oral administration at the equivalent daily dosage and frequency of the intravenous administration.

Compatibility and Stability
VIMPAT injection can be administered intravenously without further dilution or may be mixed with diluents. VIMPAT injection was found to be physically compatible and chemically stable when mixed with the following diluents for at least 4 hours and stored in glass or polyvinyl chloride (PVC) bags at ambient room temperature 15-30°C (59-86°F).

Diluents:
Sodium Chloride Injection 0.9% (w/v)
Dextrose Injection 5% (w/v)
Lactated Ringer's Injection

The stability of VIMPAT injection in other infusion solutions has not been evaluated. Product with particulate matter or discoloration should not be used.
Any unused portion of VIMPAT injection should be discarded.


Storage (vials):
Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° to 30°C (59° to 86°F).

Do not freeze Vimpat injection or oral solution. Discard any unused Vimpat oral solution remaining after seven (7) weeks of first opening the bottle.


Patients with Renal Impairment
No dose adjustment is necessary in patients with mild to moderate renal impairment. A maximum dose of 300 mg/day VIMPAT is recommended for patients with severe renal impairment [creatinine clearance
(CLCR) leq30mL/min] and in patients with endstage renal disease. VIMPAT is effectively removed from plasma by hemodialysis. Following a 4-hour hemodialysis treatment, dosage supplementation of up to 50% should be considered. In all renally impaired patients, the dose titration should be performed with caution.

Patients with Hepatic Impairment
The dose titration should be performed with caution in patients with hepatic impairment. A maximum dose of 300 mg/day is recommended for patients with mild or moderate hepatic impairment.

VIMPAT use is not recommended in patients with severe hepatic impairment.

DOSAGE FORMS AND STRENGTHS
[ 1] 50 mg (pink), 100 mg (dark yellow), 150 mg (salmon), and 200 mg (blue) film-coated tablets
[ 2] 200 mg/20mL injection
[ 3] 10 mg/mL oral solution

levetiracetam - Keppra®: top of page

INDICATIONS AND USAGE
KEPPRA is an antiepileptic drug indicated for adjunctive therapy in the treatment of:

-Partial onset seizures in patients one month of age and older with epilepsy.
-Myoclonic seizures in patients 12 years of age and older with juvenile myoclonic epilepsy.
-Primary generalized tonic-clonic seizures in patients 6 years of age and older with idiopathic generalized epilepsy.

KEPPRA XR is an antiepileptic drug indicated for adjunctive therapy in the treatment of partial onset seizures in patients geq16 years of age with epilepsy

DOSAGE AND ADMINISTRATION
Oral Solution:
Use the oral solution for pediatric patients with body weight leq 20 kg.
For pediatric patients, use weight-based dosing for the oral solution with a calibrated measuring device (not a household teaspoon or tablespoon).

Partial Onset Seizures
1 Month To < 6 Months: 7 mg/kg twice daily, increase in increments of 7 mg/kg twice daily every 2 weeks to recommended dose of 21 mg/kg twice daily.
6 Months To < 4 Years: 10 mg/kg twice daily, increase in increments of 10 mg/kg twice daily every 2 weeks to recommended dose of 25 mg/kg twice daily.
4 Years To < 16 Years: 10 mg/kg twice daily, increase in increments of 10 mg/kg twice daily every 2 weeks to recommended dose of 30 mg/kg twice daily.
Adults 16 Years And Older: 500 mg twice daily, increase as needed and tolerated in increments of 500 mg twice daily every 2 weeks to a maximum recommended dose of 1500 mg twice daily.

Myoclonic Seizures In Adults and Pediatric Patients 12 Years And Older
500 mg twice daily, increase by 500 mg twice daily every 2 weeks to recommended dose of 1500 mg twice daily.

Primary Generalized Tonic-Clonic Seizures:
6 Years To < 16 Years: 10 mg/kg twice daily, increase in increments of 10 mg/kg twice daily every 2 weeks to recommended dose of 30 mg/kg twice daily.
Adults 16 Years And Older: 500 mg twice daily, increase by 500 mg twice daily every 2 weeks to recommended dose of 1500 mg twice daily.

Adult patients with impaired renal function
Dose adjustment is recommended, based on the patient's estimated creatinine clearance.

XR Tablets:  KEPPRA XR is an antiepileptic drug indicated for adjunctive therapy in the treatment of partial onset seizures in patients geq16 years of age with epilepsy:
Treatment should be initiated with a dose of 1000 mg once daily. The daily dosage may be adjusted in increments of 1000 mg every 2 weeks to a maximum recommended daily dose of 3000 mg.
See full prescribing information for use in patients with impaired renal function.

Injection - Single-use 100 mL bags for injection and 500 mg/5 mL single-use vial
Levetiracetam in Sodium Chloride Injection is an antiepileptic drug indicated for adults (16 years and older) with the following seizure types when oral administration is temporarily not feasible.

Partial onset seizures
Myoclonic seizures in patients with juvenile myoclonic epilepsy
Primary generalized tonic-clonic seizures

For intravenous use only. Do not dilute prior to its use.
Administer dose-specific 100 mL bag intravenously over 15-minutes.
Levetiracetam can be initiated with either intravenous or oral administration.

Single use vials (500mg/5ml):
Levetiracetam injection should be diluted in 100 mL of a compatible diluent and administered intravenously as a 15-minute infusion

Initial Exposure to Levetiracetam
Partial Onset Seizures: Initial dose is 1000 mg/day, divided as 500 mg twice daily. Increase dose as needed and tolerated in increments of 1000 mg/day, every 2 weeks to a maximum recommended daily dose of 3000 mg.
Myoclonic Seizures in Patients with Juvenile Myoclonic Epilepsy: Initial dose is 1000 mg/day, divided as 500 mg twice daily. Increase dose by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been studied.

Primary Generalized Tonic-Clonic Seizures: Initial dose is 1000 mg/day, divided as 500 mg twice daily. Increase dose by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg. The effectiveness of doses lower than 3000 mg/day has not been adequately studied (2.2).

Switching to Intravenous Dosing: Initial total daily intravenous levetiracetam dose regimen should be equivalent to total daily dose and frequency of oral levetiracetam.

Switching to Oral Dosing: Give equivalent daily dose and frequency of oral as intravenous levetiracetam.

Renal Impairment: Dose adjustment necessary based on creatinine clearance

Dosing Adjustment Regimen for Adult Patients with Impaired Renal Function
Group Creatinine
Clearance
(mL/min)
Dosage
(mg)
Frequency
Normal > 80 500 to 1,500 Every 12 h
Mild 50 to 80 500 to 1,000 Every 12 h
Moderate 30 to 50 250 to 750 Every 12 h
Severe < 30 250 to 500 Every 12 h
ESRD patients using dialysis ---- 500 to 1,000 1Every 24 h
1. Following dialysis, a 250 to 500 mg supplemental dose is recommended.


DOSAGE FORMS AND STRENGTHS
Tablets: 250 mg, 500 mg, 750 mg, and 1000 mg film-coated, scored tablets
Solution: 100 mg/mL solution
XR tablets:   500 mg, 750 mg film-coated extended-release tablet.

Single-use 100 mL bags for injection:
Levetiracetam in 0.82 % sodium chloride (500 mg/100 mL)
Levetiracetam in 0.75 % sodium chloride (1000 mg/100 mL)
Levetiracetam in 0.54% sodium chloride (1500 mg/100 mL)

500 mg/5 mL single-use vial

lamotrigine - Lamictal®: top of page

DOSAGE AND ADMINISTRATION
Dosing (Adults):  
Adjunctive treatment of Lennox-Gastaut or partial seizures: Patients receiving AED regimens containing valproic acid: Initial dose: 25 mg every other day x 2 weeks, then 25 mg qd x 2 weeks. Dose may be increased by 25-50 mg qd x 1-2 weeks in order to achieve maintenance dose.

Maintenance dose: 100-400 mg/day in 1-2 divided doses (usual range 100-200 mg/day).   

Patients receiving enzyme-inducing AED regimens without valproic acid: Initial dose: 50 mg/day x 2 weeks, then 100 mg in 2 doses x 2 weeks; thereafter, daily dose can be increased by 100 mg every 1-2 weeks to be given in 2 divided doses. Usual maintenance dose: 300-500 mg/day in 2 divided doses.

Bipolar disorder: 25 mg/day x 2 weeks, followed by 50 mg/day x 2 weeks, followed by 100 mg/day x 1 week. Thereafter, daily dosage may be increased to 200 mg/day.

Patients receiving valproic acid: Initial: 25 mg every other day x 2 weeks, followed by 25 mg/day x 2 weeks, followed by 50 mg/day x 1 week, followed by 100 mg/day (target dose) thereafter. Note: If valproate is discontinued, increase daily lamotrigine dose in 50 mg increments at weekly intervals until daily dosage of 200 mg is attained.

Patients receiving enzyme-inducing drugs: Initial: 50 mg/day x 2 weeks, followed by 100 mg/day (in divided doses) x 2 weeks, followed by 200 mg/day (in divided doses) x 1 week, followed by 300 mg/day (in divided doses) x 1 week. May increase to 400 mg/day (in divided doses) during week 7 and thereafter.
 Note: If carbamazepine (or other enzyme-inducing drug) is discontinued, decrease daily lamotrigine dose in 100 mg increments at weekly intervals until daily dosage of 200 mg is attained.

Possible life-threatening rash. 

DOSAGE FORMS AND STRENGTHS
[Supplied: 25, 100, 150, 200mg tablets]

lorazepam - Ativan®: top of page

DOSAGE AND ADMINISTRATION
Dosing (Adults): 
Antiemetic: Oral, IV:  0.5-2 mg every 4-6 hours as needed.   

Anxiety and sedation: Oral: 1-10 mg/day in 2-3 divided doses; usual dose: 2-6 mg/day in divided doses; initial dose should not exceed 2 mg in debilitated patients. 

Insomnia: Oral: 2-4 mg at bedtime.    

Preoperative:  IM: 0.05 mg/kg administered 2 hours before surgery; maximum: 4 mg/dose.  IV: 0.044 mg/kg 15-20 minutes before surgery; usual maximum: 2 mg/dose.  

Status epilepticus: IV: 4 mg/dose given slowly over 2-5 minutes; may repeat in 10-15 minutes; usual maximum dose: 8 mg.    

Rapid tranquilization of agitated patient (administer every 30-60 minutes):   
Oral: 1-2 mg. IM: 0.5-1 mg.  

Agitation in the ICU patient (unlabeled):  
IV: 0.02-0.06 mg/kg every 2-6 hours. Alternatively - IV infusion: 0.01-0.1 mg/kg/hour.

Onset:   
Hypnosis: IM: 20-30 minutes.
Sedation: IV: 5-20 minutes.
Anticonvulsant: IV: 5 minutes, oral: 30-60 minutes.

Duration:
6-8 hours.

DOSAGE FORMS AND STRENGTHS
Supplied:  Injection: 2 mg/ml (1 ml, 10 ml); 4 mg/ml (1 ml, 10 ml). Oral concentrate: 2 mg/ml (30 ml). Tablet: 0.5 mg, 1 mg, 2 mg.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
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