Vimpat

<1month (partial-onset seizures) or <4yrs (primary tonic-clonic seizures): not established. See full labeling. Tabs: swallow whole. Oral soln: use calibrated measuring device. Injection: can give without diluting, or may be mixed with appropriate diluent and give by IV infusion preferably over 30–60mins. ≥1month: Partial-onset seizures: (<6kg): Oral: initially 1mg/kg twice daily; may increase at weekly intervals by 2mg/kg/day in 2 divided doses; maintenance dose: 7.5–15mg/kg/day; IV: 0.66mg/kg 3 times daily; may increase at weekly intervals by 2mg/kg/day in 3 divided doses; maintenance dose: 7.5–15mg/kg/day; (6–<11kg): Oral and IV: initially 1mg/kg twice daily; may increase at weekly intervals by 2mg/kg/day in 2 divided doses; maintenance dose: 6–12mg/kg/day. Partial-onset or tonic-clonic seizures (4–<17yrs): Oral and IV: (11–<30kg): initially 1mg/kg twice daily; may increase at weekly intervals by 2mg/kg/day in 2 divided doses; maintenance dose: 6–12mg/kg/day; (30–<50kg): initially 1mg/kg twice daily; may increase at weekly intervals by 2mg/kg/day in 2 divided doses; maintenance dose: 4–8mg/kg/day; (≥50kg): initially 50mg twice daily; may increase at weekly intervals by 100mg/day in 2 divided doses; maintenance dose: 300–400mg/day (monotherapy for partial-onset seizures) or 200–400mg/day (adjunct for partial-onset or tonic-clonic seizures). Switching from oral to IV (≥6kg): give same dosing regimens as that described for oral dosing; <6kg: follow IV dosing above. Severe renal impairment (CrCl<30mL/min), ESRD, mild to moderate hepatic impairment: reduce max dose by 25%; if concomitant strong CYP3A4/CYP2C9 inhibitors: may need dose reduction. Consider supplemental dose (up to 50%) after hemodialysis. Avoid abrupt cessation (withdraw over ≥1 week).