Ezogabine Dosage

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Usual Adult Dose for:

Usual Geriatric Dose for:

Additional dosage information:

Usual Adult Dose for Epilepsy

Initial dose: 100 mg orally 3 times daily. The dose may be increased by a maximum of 50 mg 3 times daily (150 mg per week) based on clinical response.
Maintenance dose: 200 to 400 mg orally 3 times daily (600 to 1,200 mg orally daily). Note: 400 mg 3 times daily showed limited evidence of additional improvement in seizure reduction, but an increase in adverse events and discontinuations, compared to the 300 mg 3 times daily dosage.
Maximum dose: 400 mg orally 3 times daily (1,200 mg orally daily)

Approved indication: As adjunctive treatment of partial-onset seizures in patients 18 years and older who have responded inadequately to several alternative treatments and for whom the benefits outweigh the risk of retinal abnormalities and potential decline in visual acuity.

Usual Geriatric Dose for Epilepsy

Initial dose: 50 mg orally 3 times daily. The dose may be increased by a maximum of 50 mg 3 times daily (150 mg per week) based on clinical response.
Maximum dose: 250 mg orally 3 times daily (750 mg orally daily)

Approved indication: As adjunctive treatment of partial-onset seizures in patients 18 years and older who have responded inadequately to several alternative treatments and for whom the benefits outweigh the risk of retinal abnormalities and potential decline in visual acuity.

Renal Dose Adjustments

CrCl 50 to 80 mL/min: No dose adjustment recommended

CrCl less than 50 mL/min or end-stage renal disease on dialysis:
Initial dose: 50 mg orally 3 times daily. The dose may be increased by a maximum of 50 mg 3 times daily (150 mg per week) based on clinical response.
Maximum dose: 200 mg orally 3 times daily (600 mg orally daily)

Liver Dose Adjustments

Child-Pugh score 5 to 6: No adjustment recommended

Child-Pugh score 7 to 9:
Initial dose: 50 mg orally 3 times daily. The dose may be increased by a maximum of 50 mg 3 times daily (150 mg per week) based on clinical response.
Maximum dose: 250 mg orally 3 times daily (750 mg orally daily)

Child-Pugh score greater than 9:
Initial dose: 50 mg orally 3 times daily. The dose may be increased by a maximum of 50 mg 3 times daily (150 mg per week) based on clinical response.
Maximum dose: 200 mg orally 3 times daily (600 mg orally daily)

Dose Adjustments

Ezogabine should be titrated according to clinical response in order to achieve therapeutic efficacy and minimize adverse effects.

When discontinuing ezogabine, the dosage should be gradually reduced over a period of at least 3 weeks, unless safety concerns require abrupt withdrawal.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Dosage reduction is recommended for patients with creatinine clearance less than 50 mL/min and for patients
with end-stage renal disease receiving dialysis.

Other Comments

Ezogabine may cause retinal abnormalities with long-term use. If patients fail to show substantial clinical benefit after adequate titration, ezogabine should be discontinued. Testing of visual function should be done at baseline and every 6 months during therapy with. Patients who cannot be monitored should not be treated. If retinal pigmentary abnormalities or vision changes are detected, ezogabine should be discontinued unless no other suitable treatment options are available and the benefits of treatment outweigh the potential risk of vision loss.

Ezogabine may be administered with or without food.

Ezogabine should be swallowed whole and not crushed, chewed, or divided.

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