CLINICAL USE

Anti-epileptic

DOSE IN NORMAL RENAL FUNCTION

Initially: 25 mg twice daily, increasing to maintenance dose of 300–500 mg daily in 1 or 2 divided doses

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 212.2
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 40–60
  • %Excreted unchanged in urine &nbsp &nbsp : 15–35

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp : 0.8–1.6

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : 60–63/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function, titrate slowly.
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function, titrate slowly.

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp : Dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: Probably dialysed. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antidepressants: anticonvulsant effect antagonised by MAOIs, SSRIs and tricyclics
  • Antimalarials: possibly increased risk of convulsions with chloroquine and hydroxychloroquine; anticonvulsant effect antagonised by mefloquine

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    AUC is increased by 35% in patients with a GFR<20 mL/min Increase dose at 2 weekly intervals in people with renal impairment and monitor more frequently .
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