Adverse Reaction:
Side effects-
Anorexia abdominal pain, naisea, vomiting, dyspepsia, diarrhoea, cough,
naspharyngitis, vertigo, drowsiness, ataxia, convulsions, dizziness, headache,
tremor, malaise, aggression, depression, insomnia, anxiety, irritability, rash
less commonly,
weight changes,parasetheia, impaired attention, agitation, amnesia,
confusion, psychosis, suicidal ideation( completed suicide also reported)
myalgia, blurred vision
rarely
hepatic failure, dyskinesia, agranulocytosis,pancytopenia, drug reaction
with eosinophoilia, Steven-Jognsonsyndrome, erythemia multiforme
Contra-Indications:
Cautions-
avoid abrupt withdrawal
Dosages/ Overdosage Etc:
Indication-
Focal seizures with or without secondary generalisation and
for adjunctive therapy of myoclonic seizures in patients
and adolescents from 12 years of age with juvenile
myoclonic epilepsy .
Dose-
Monotherapy of focal seizures, bymouth or
by intravenous infusion,
Adult and Child over 16 years
initially 250mg once daily, therafter increasing acording to
respond in steps of 250mg twice daily every 2 weeks.
Max 1.5mg twice daily
Adjunctive therapy offocal seizures, by mouth
Adult- and child over 12 years , body weight over 50kg
initially 250mg twice daily, increased by 500mg twice daily
every 2-4 weeks max- 1.5mg twice daily
Child over 6 months, initially 7mg/kg once daily, increased
by max 7mg/kg twice daily every 2 weeks, max, 21mg/kg twice daily
By intravenous infusion-
Adult and child over 12 years-body weight 50g
initially 250mg twice daily every 2-4 weeks ,
max 1.5g twice daily
Child over 4 years-body weight under 50kg
initially 10mg/kg once daily , increased by max. 10mg/kg twice
daily every 2 weeks. Max. 30mg/kg twice daily
Pregnancy and lactation:
Pregnancy-
Women of child-bearing potential should discuss with a specialist
the imact of both epilepsy and its treatment,on the outcome of pregnancy
Breast -feeding-
Women taking antiepileptic monotherapy should generally encouraged to
breast-feed if a women is on a combination therapy or if there are other risk
factors, such as premature birth, specialist advice should be sought.