Monotherapy Adult & adolescent ≥16 yr Recommended starting dose: 250 mg bd, increase to an initial therapeutic dose of 500 mg bd after 2 wk. Can be further increased by 250 mg bd every 2 wk depending upon clinical response. Max dose: 1,500 mg bd.
Adult weighing >50 kg w/ renal impairment: CrCl >80 mL/min/1.73 m2 500-1,500 mg bd,
50-79 mL/min/1.73 m2 500-1,000 mg bd,
30-49 mL/min/1.73 m2 250-750 mg bd,
<30 mL/min/1.73 m2 250-500 mg bd,
ESRD/patient undergoing dialysis 500-1,000 mg once daily. Loading dose: 750 mg on the 1st day of treatment. Supplemental dose: 250-500 mg following dialysis.
Add-on therapy Adult & adolescent 12-17 yr weighing ≥50 kg Initially 500 mg bd. Can be increased up to 1,500 mg bd depending upon clinical response & tolerability. Dose changes can be made in 500 mg bd increases or decreases every 2-4 wk.
Adolescent 12-17 yr & childn 4-11 yr weighing <50 kg Initially 10 mg/kg bd. Can be increased up to 30 mg/kg bd depending upon clinical response & tolerability. Dose changes should not exceed increases or decreases of 10 mg/kg bd every 2 wk; use lowest effective dose.