Adults: Epilepsy: Adults and children over 12 years of age. Initial dosage: either 200 mg b.i.d. for tablets and controlled release tablets, or 1 teaspoon q.i.d. for suspension (400 mg/day). Increase at weekly intervals by adding up to 200 mg/day, using a b.i.d., t.i.d. or q.i.d. regimen of either formulation, until the optimal response is obtained. In children 12-15 years of age, the dosage generally should not exceed 1000 mg daily, and 1200 mg daily in patients above 15 years of age. Doses up to 1600 mg daily have been used in adults in rare instances. Maintenance: usually 800-1200 mg daily.
Children 6-12 years of age. Initial dosage: either 100 mg b.i.d. for tablets or controlled release tablets, or 1/2 teaspoon q.i.d. for suspension (200 mg/day). Increase at weekly intervals by adding up to 100 mg/day, using a b.i.d., t.i.d. or q.i.d. regimen of either formulation, until the optimal response is obtained. Dosage generally should not exceed 1000 mg daily. Maintenance: usually 400-800 mg daily.
Children under 6 years of age. Initial dosage: 10-20 mg/kg/day given b.i.d. or t.i.d. as tablets, or q.i.d. as suspension. Increase weekly to achieve the optimal clinical response, administered t.i.d. or q.i.d. Maintenance: ordinarily, the optimal clinical response is achieved at daily doses below 35 mg/kg. If a satisfactory clinical response has not been achieved, plasma levels should be measured to determine whether or not they are in the therapeutic range. No recommendation can be made regarding the safety of Carbamazepine at doses above 35 mg/kg/24 hours.
Combination therapy: Carbamazepine may be used alone or with other anticonvulsants. When added to existing anticonvulsant therapy, the drug should be added gradually while the other anticonvulsants are maintained or gradually decreased, except phenytoin, which may have to be increased.
Trigeminal Neuralgia. Initial dosage: on the first day, either 100 mg b.i.d. for tablets or controlled release tablets, or 1/2 teaspoon q.i.d. for suspension, for a total daily dose of 200 mg. This daily dose may be increased by up to 200 mg/day, using increments of 100 mg every 12 hours for tablets or controlled release tablets, or 50 mg (1/2 teaspoon) q.i.d. for suspension, only as needed to achieve freedom from pain. A total dose of 1200 mg daily should not be exceeded. Maintenance: control of pain can be maintained in most patients with 400-800 mg daily. However, some patients may be maintained on as little as 200 mg daily, while others may require as much as 1200 mg daily. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level, or even to discontinue the drug. The tablets or syrup can be taken without regard to meals.