Eslicarbazepine Dosage

Usual Adult Dose for Seizures

-Initial dose: 400 mg orally once a day; some patients may be initiated at 800 mg orally once a day if the need for seizure reduction outweighs an increased risk of adverse reactions
-Dose titration: Increase dosage by 400 to 600 mg weekly, based on response and tolerability
-Maintenance dose: 800 to 1600 mg orally once a day

Comments:
-For patients on monotherapy, the 800 mg once a day maintenance dose should be considered in patients who are unable to tolerate a 1200 mg once a day dose.
-For patients on adjunctive therapy, the 1600 mg once a day dose should be considered in patients who did not achieve a satisfactory response with a 1200 mg once a day dose.

Comments:
-This drug may be taken without regard to meals.
-Tablets may be swallowed whole or crushed.
-A maximum dose of 1200 mg daily should only be initiated after the patient has tolerated 800 mg daily for at least a week.
-For some patients, treatment may be initiated at 800 mg once daily if the need for additional seizure reduction outweighs an increased risk of adverse reactions.
-This drug should not be taken as an adjunctive therapy with oxcarbazepine.

Approved indication: For the treatment of partial-onset seizures as monotherapy or adjunctive therapy

Renal Dose Adjustments

-CrCl 50 mL/min or greater: No adjustment recommended
-CrCl less than 50 mL/min: The initial, titration, and maintenance dosages should generally be reduced by 50%; titration and maintenance dosages may be adjusted according to clinical response.

Liver Dose Adjustments

-Mild to moderate liver impairment: No adjustment recommended
-Severe liver impairment: Data not available

Dose Adjustments

-The dosage should be reduced gradually to minimize the risk of increased seizure frequency and status epilepticus.
-Carbamazepine reduces the plasma concentration of this drug. When this drug and carbamazepine are taken concomitantly, the dose of one of the two drugs may need to be adjusted based on efficacy and tolerability.
-For patients taking other enzyme-inducing antiepileptic drugs (AEDs) (i.e., phenobarbital, phenytoin, primidone), higher doses of this drug may be needed.
-This drug should not be taken as an adjunctive therapy with oxcarbazepine.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis removes metabolites from plasma

Other Comments

Administration advice:
-This drug may be taken without regard to meals.
-Tablets may be swallowed whole, divided, or crushed.