Dose range: 150-600 mg daily given in either 2 or 3 divided doses. Epilepsy Initially 150 mg daily as 2 or 3 divided doses, may be increased to 300 mg daily after 1 wk. Max: 600 mg daily may be achieved after an additional wk. GAD Initially 150 mg daily, may be increased to 300 mg daily after 1 wk. Following an additional wk, dose may be increased to 450 mg daily. Max: 600 mg daily may be achieved after an additional wk. Patient w/ renal impairment CrCl ≥60 mL/min Initially 150 mg daily given bid or tid. Max: 600 mg daily, ≥30-<60 mL/min Initially 75 mg daily given bid or tid. Max: 300 mg daily, ≥15-<30 mL/min Initially 25-50 mg daily given once daily or bid. Max: 150 mg daily, <15 mL/min Initially 25 mg daily given once daily. Max: 75 mg daily, supplementary dose following hemodialysis Initially 25 mg as single dose. Max: 100 mg daily.
Discontinue use immediately if symptoms of angioedema (eg, facial, perioral, or upper airway swelling) occur. Reports of loss of consciousness, confusion & mental impairment; visual adverse reactions including loss of vision, visual blurring or other changes of visual acuity; CHF mostly seen in elderly CV compromised patients during treatment for neuropathic indication; increased CNS adverse reactions & somnolence in the treatment of central neuropathic pain due to spinal injury; encephalopathy mostly in patients w/ underlying conditions that precipitate encephalopathy. Insufficient data on w/drawal of concomitant antiepileptic medicinal products. W/drawal symptoms after discontinuation of short- & long-term treatment. Adjust hypoglycemic medicinal products in diabetic patients who gained wt during treatment. Monitor patients for signs of suicidal ideation & behaviors. Exercise caution in patients w/ history of substance abuse & monitor for symptoms of misuse, abuse or dependence. Reduced lower GI tract function (eg, intestinal obstruction, paralytic ileus, constipation) when co-administered w/ medications that have the potential to produce constipation (eg, opioid analgesics). Cases of renal failure. Use only during pregnancy if potential benefit justifies potential risk to the fetus. Breastfeeding is not recommended during treatment. Safety & efficacy in childn <1 yr & adolescents 12-17 yr have not been established. Dizziness & somnolence may occur which could increase the occurrence of accidental injury (fall) in elderly.
May potentiate effects of ethanol & lorazepam. Reports of resp failure & coma w/ other CNS depressants. Additive effect in the impairment of cognitive & gross motor function caused by oxycodone.
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