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Mechanism of action not understood; antiepileptic effects may be due to the actions of blocking sodium channels in neurons with sustained depolarization; increasing GABA activity at receptors, thus potentiating the effects of this inhibitory neurotransmitter; and blocking excitatory neurotransmitters at neuron receptor sites.
400 mg PO daily in 2 divided doses; begin adjustment of dose at 25\u201350 mg/day in the evening for wk 1; 50 mg AM and PM for wk 2; 50 mg AM and 100 mg PM for wk 3; 100 mg AM and PM for wk 4; 100 mg AM and 150 mg PM for wk 5; 150 mg AM and PM for wk 6; 150 mg AM and 200 mg PM for wk 7; and 200 mg AM and PM for wk 8 and beyond.
5\u20139 mg/kg/day PO in 2 divided doses, as adjunctive therapy for Lennox-Gastaut
syndrome; begin therapy at < 25 mg and increase in increments of 1\u20133 mg/kg/day every
For creatinine clearance < 70 mL/min, use one-half the usual dose; allow increased time
to reach desired level. For patients with hepatic impairment, adjust slowly; monitor
Metabolism: Hepatic; T1/2: 21 hr
Distribution: Crosses placenta; enters breast milk
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