All the Drug Class Drugs
Anticonvulsant. Sodium Valproate 200 mg, 500 mg. EC Tabs. 40X200 mg, 500 mg
SOL.50 mlX200 mg/ml
SYR. 110 mlX200 mg/5ml
Init: 10-15 mg/kg bw dly, incr. at 5 days or 1 week interv. by 5 mg/kg bw. Elderly:15 mg/kg dly. Adults:20 mg/kg dly. Child and inf.: 25 mg/kg daily. Assess after 2-3 weeks treat. See lit.
Generalized or partial epilepsy, secondary generalized
epilepsy and mixed forms of epilepsy
C/I: Pregnancy unless no suitable alternat.
Women of childbearing potent.
Hypersens. to valproate, valproate semisodium, valpromide or excipients
Accute hepatitis.
Chron. hepatitis.
Pts. or family hist. of sev. hepatitis, especial. drug-related.
Hepat. porphyria.
Pts. with known urea cycle dis.
Pts. with mitoch. dis. caused by mut. in the nuclear gene encoding mitoch. enzyme polymerase gamma (POLG), e.g. Alpers-Huttenlocher Syndr., childr. under 2 years suspect. of having a POLG related dis.
Combinat. with St John’s Wort
Anti-Epileptic, Anticonvulsant. Sodium Valproate 333 mg, Valproic Acid 145 mg. P.R. TABS: 30. The Init. dly. dosage is usually 10-15 mg/kg, after which doses are incr. up to the optim. dose.
The mean dosage is 20-30 mg/kg/d. However, if seizures are not brought under control at this dosage it may be incr. and pts. must be closely monitor.
In child., usually 30 mg/kg/d.
In adults, usually 20 to 30 mg/kg/d.
In elderly pts., the dosage should be determ. based on the control of seizur. Tmt. and preven. of manic episodes in the context of bipolar disord.: The recomm. init. dose is 1000 mg/d. The dose should be incr. as fast as possible to the low. dose that brings about the desired clinic. effect. The recomm. mainten. dose for the tmt. of bipolar disord. is between 1000 mg & 2000 mg dly. In except. cases the dose may be incr. to a max. of 3000 mg dly. Dosage should be adjust. individ. See lit.
Epilepsy: Tmt. of general./partial epilep. second. epilep. and mixed forms of epilep.
Bipolar disord.: Tmt. and/or prevent. of acute manic episodes in the context of bipolar disord.
C/I: History of hypersens. to valproate, divalproate, valpromide. Acute hepatit. Chron. hepatit. Hep. porphyria. Person./famil. history of sev. hepatit., in particular drug-related.
Comb. use with mefloquine and St.-John`s-wort. Pts. known to have mitochond. disord. caused by mutations in the nuclear gene encod. mitochond. enzyme polymerase γ (POLG, e.g. Alpers-Huttenlocher Syndr.). Pts. with known urea cycle disord.
Anticonvulsant. Phenytoin Sodium 125 mg/5 ml. SUSP: 237 ML
Dosage should be individualiz. to provide max. benefit. In some cases serum blood level determinat.may be necessary for optimal dosage adjust.—the clinically effect. serum level is usually 10–20 mcg/mL although some mild cases of tonic-clonic (grand mal) epilepsy may be control. with lower serum levels of phenytoin. Adult.: Pts who have received no prev. tmt. may be started 5ml×3/d, and the dose is then adjust. to suit individ. requirem. An incr. to 25ml dly. (625mg), may be made, if necessary.
An oral load. dose may be used for non-emergency init. of ther. in adult. who require rapid steady state serum levels, and for whom IV admin. is not desirable. This dosing regimen should be reserved for pts. in a clinic/hospital setting where phenytoin serum levels can be closely monitor.Pts. with a history of renal or hep. dis. should not receive the oral load. dose regimen.
The recomm. oral load. dose is 1 gr of phenytoin divid. into three doses (400, 300, 300 mg) and admin. at two hour interv. Normal mainten. dosage is then instituted 24 hrs. after the load. dose, with frequent serum level determinations.
Elder. Pts.: Phenytoin clearance is decreased slightly in elderly pts. and lower or less freq. dosing may be require.
Ped.: Init., 5 mg/kg/day in two or three equally divid. doses, with subseq. dosage individual.to a max. of 300 mg dly. A recomm. dly. mainten. dosage is usually 4- 8 mg/kg. Child. over 6 yrs. and adolescents may require the minim.adult dose (300 mg/d.). See lit.
For the control of tonic clonic (Grand- mal) and psychomotor (Temporal lobe seizures).
C/I:
History of hypersens. to phenytoin
A history of prior acute hepatotox. attributable to phenytoin.
Coadmin. with delavirdine because of the potent. for loss of virologic response and possible resistance to delavirdine or to the class of non-nucleoside reverse transcriptase inhib.
Anticonvulsant. Phenytoin Sodium 100 mg. CAPS: 100.
Adult.: Divid. dly. dosage: For oral caps., pts. who have received no prev.tmt. may be init. on 300 mg dly., to be taken in three equal. divid. doses, and the dosage then adjust. to suit individ. requir. For most adult., the satisfactory mainten. dosage will be 300 mg- 400 mg dly., to be taken in three -four equal. divid. doses respectiv. An incr. up to 600mg dly. may be made if necessary.
Non-emergency oral load. dose in adult pts.: An oral load. dose may be used for non-emergen. initiat. of ther. in adult. who require rapid stead. state serum levels, and for whom IV admin. is not desirable. This dosing regimen should be reserved for pts. in a clinic or hospital setting where serum levels can be closely monitor.
Pts. with a hist. of renal / hep. dis. should not receive the oral load. dose regimen.
The recomm. oral load. dose is 1 gr divid. into three doses (400 mg, 300 mg, 300 mg) and admin. at two-hour intervals. Normal mainten. dosage is then instituted 24 hrs. after the load. dose, with freq. serum level determinat.
Ped. pts.
For oral caps., init., 5 mg/kg/d in two / three equal. divid. doses with subsequent dosage individualiz. to a max. of 300 mg dly. A recomm. dly. maintenan. dosage is usually 4 to 8 mg/kg.
Child. over 6 yrs. and adolesc. may requir. the min. adult dose (300 mg/d). If the daily dosage cannot be divid.equally, the larger dose should be given at bdtme.
See lit.
Tmt. of epilepsy.
C/I: A hist. of hypersens. phenytoin (Reac. have includ. angioedema).
A history of prior acute hepatotox. attributab.to phenytoin .
Coadmin. with delavirdine. See lit.
Anticonvulsant. Rufinamide 100, 200, 400 mg. F.C. TABS: 10 x 100 mg, 60 x 200 mg, 400
mg. See lit.
Adjunct. ther. tmt. seizures assoc. with
Lennox-Gastaut syndr. in pts. > 4 yrs.
C/I: Hypersens.
Anticonvulsant. Levetiracetam 100 mg/ml. ORAL SOLN: 300 ml x 100 mg/ml. Adult,
child & adolesc. 12-17 yrs, wt. 50 kg or
more: Initial: 500 mg 2 x dly on 1st day
of tmt. Depend. on clin. response/
tolerabil. can incr. dly dose up to 1,500
mg 2 x dly. Dose changes can be made
in 500 mg increments/decrements 2 x
dly every 2-4 wks. Child 4-17 yrs wt.
less than 50 kg: Initial 10 mg/kg body
wt 2 x dly. Depend. on clin./tolerabil,.
incr. up to 30 mg/kg bdy wt. 2 x dly
every 2 wks. Dose changes not to
exceed increments/decrements of 10
mg/kg bdy wt. 2 x dly every 2 wks. Use
lowest effect. dose. Inf./child under 4
yrs: Not recommend. Elderly: Adjust if
renal funct. compromised. Renal
impair: Adjust individ. accord. to ren.
funct. Severe hepat. impair: Creatinine
clear. may underest. ren. insuffic; 50%
reduct. dly maint. dose is recommend.
at creatinine clear. of <70 ml/min.
Adjunct. ther. tmt partial onset seiz. with/
without second. generaliz. pts with
epilepsy.
C/I: Hypersens.
