Show pageDiscussionOld revisionsBacklinksCite current pageBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ====== AED dosing and target serum concentration ====== <html> <style type="text/css"> .tg {border-collapse:collapse;border-spacing:0;border-color:#9ABAD9;} .tg td{font-family:Arial, sans-serif;font-size:14px;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:#9ABAD9;color:#444;background-color:#EBF5FF;} .tg th{font-family:Arial, sans-serif;font-size:14px;font-weight:normal;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:#9ABAD9;color:#fff;background-color:#409cff;} .tg .tg-hmp3{background-color:#D2E4FC;text-align:left;vertical-align:top} .tg .tg-0lax{text-align:left;vertical-align:top} </style> <table class="tg"> <tr> <th class="tg-0lax">Drug</th> <th class="tg-0lax">Brand Name</th> <th class="tg-0lax">Initial or Starting Dose</th> <th class="tg-0lax">Usual Range or Maximum Dose</th> <th class="tg-0lax">Comments Target Serum Concentration Range</th> </tr> <tr> <td class="tg-0lax">Barbiturates</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Phenobarbital</td> <td class="tg-0lax">Various</td> <td class="tg-0lax">1-3 mg/kg/d (10-20 mg/kg LD)</td> <td class="tg-0lax">180-300 mg</td> <td class="tg-0lax">10-40 μg/mL (43-172 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Primidone</td> <td class="tg-0lax">Mysoline</td> <td class="tg-0lax">100-125 mg/d</td> <td class="tg-0lax">750-2000 mg</td> <td class="tg-0lax">5-10 μg/mL (23-46 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Benzodiazepines</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Clobazam</td> <td class="tg-0lax">Onfi</td> <td class="tg-0lax">≤30 kg 5 mg/d; >30 kg 10 mg/d</td> <td class="tg-0lax">≤30 kg up to 20 mg; > 30 kg up to 40 mg</td> <td class="tg-0lax">0.03-0.3 ng/mL (0.1-1.0 nmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">20 mg</td> <td class="tg-0lax">20-70 ng/mL (0.06-0.22 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Clonazepam</td> <td class="tg-0lax">Klonopin</td> <td class="tg-0lax">1.5 mg/d</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Diazepam</td> <td class="tg-0lax">Valium</td> <td class="tg-0lax">PO: 4-40 mg</td> <td class="tg-0lax">PO: 4-40 mg</td> <td class="tg-0lax">100-1000 ng/mL (0.4-3.5 μmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">IV: 5-10 mg</td> <td class="tg-0lax">IV: 5-30 mg</td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Lorazepam</td> <td class="tg-0lax">Ativan</td> <td class="tg-0lax">PO: 2-6 mg</td> <td class="tg-0lax">PO: 10 mg</td> <td class="tg-0lax">10-30 ng/mL (31-93 nmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">IV: 0.05 mg/kg</td> <td class="tg-0lax">IV: 0.05 mg/kg</td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">IM: 0.05 mg/kg</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Hydantoin</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Phenytoin</td> <td class="tg-0lax">Dilantin</td> <td class="tg-0lax">PO: 3-5 mg/kg (200-400 mg)</td> <td class="tg-0lax">PO: 500-600 mg</td> <td class="tg-0lax">Total: 10-20 μg/mL (40-79 μmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">(15-20mg/kg LD)</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax">Unbound: 0.5-3 μg/mL (2-12 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Succinimide</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Ethosuximide</td> <td class="tg-0lax">Zarontin</td> <td class="tg-0lax">500 mg/d</td> <td class="tg-0lax">500-2000 mg</td> <td class="tg-0lax">40-100 μg/mL (282-708 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Other</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Carbamazepine</td> <td class="tg-0lax">Tegretol</td> <td class="tg-0lax">400 mg/d</td> <td class="tg-0lax">400-2400 mg</td> <td class="tg-0lax">4-12 μg/mL (17-51 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Ezoqabine</td> <td class="tg-0lax">Potiga</td> <td class="tg-0lax">300 mg/d</td> <td class="tg-0lax">1200 mg</td> <td class="tg-0lax">Not defined</td> </tr> <tr> <td class="tg-0lax">Felbamate</td> <td class="tg-0lax">Felbatol</td> <td class="tg-0lax">1200 mg/d</td> <td class="tg-0lax">3600 mg</td> <td class="tg-0lax">30-60 μg/mL (126-252 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Gabapentin</td> <td class="tg-0lax">Neurontin</td> <td class="tg-0lax">300-900 mg/d</td> <td class="tg-0lax">4800 mg</td> <td class="tg-0lax">2-20 μg/mL (12-117 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Lacosamide</td> <td class="tg-0lax">Vimpat</td> <td class="tg-0lax">100 mg/d</td> <td class="tg-0lax">400 mg</td> <td class="tg-0lax">Not defined</td> </tr> <tr> <td class="tg-0lax">Lamotrigine</td> <td class="tg-0lax">Lamictal</td> <td class="tg-0lax">25 mg every other day if on VPA; 25-50 mg/d if not on VPA</td> <td class="tg-0lax">100-150 mg if on VPA; 300-500 mg if not on VPA</td> <td class="tg-0lax">4-20 μg/mL (16-78 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Levetiracetam</td> <td class="tg-0lax">Keppra</td> <td class="tg-0lax">500-1000 mg/d</td> <td class="tg-0lax">3000-4000 mg</td> <td class="tg-0lax">12-46 μg/mL (70-270 μmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax">Keppra XR</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Oxcarbazepine</td> <td class="tg-0lax">Trileptal</td> <td class="tg-0lax">300-600 mg/d</td> <td class="tg-0lax">2400-3000 mg</td> <td class="tg-0lax">3-35 μg/mL (MHD) (12-139 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Pregabalin</td> <td class="tg-0lax">Lyrica</td> <td class="tg-0lax">150 mg/d</td> <td class="tg-0lax">600 mg</td> <td class="tg-0lax">Not defined</td> </tr> <tr> <td class="tg-0lax">Rufinamide</td> <td class="tg-0lax">Banzel</td> <td class="tg-0lax">400-800 mg/d</td> <td class="tg-0lax">3200 mg</td> <td class="tg-0lax">Not defined</td> </tr> <tr> <td class="tg-0lax">Tiagabine</td> <td class="tg-0lax">Gabitril</td> <td class="tg-0lax">4-8 mg/d</td> <td class="tg-0lax">80 mg</td> <td class="tg-0lax">0.02-0.2 μg/mL (0.05-0.5 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Topiramate</td> <td class="tg-0lax">Topamax</td> <td class="tg-0lax">25-50 mg/d</td> <td class="tg-0lax">200-1000 mg</td> <td class="tg-0lax">5-20 mcg/mL (15-59 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Valproic acid</td> <td class="tg-0lax">Depakene</td> <td class="tg-0lax">15 mg/kg (500-1000 mg)</td> <td class="tg-0lax">60 mg/kg (3000-5000 mg)</td> <td class="tg-0lax">50-100 μg/mL (347-693 μmol/L)</td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax">Depakene SR</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax">Depakote</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax">Depakote ER</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax"></td> <td class="tg-0lax">Depacon</td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> <td class="tg-0lax"></td> </tr> <tr> <td class="tg-0lax">Vigabatrin</td> <td class="tg-0lax">Sabril</td> <td class="tg-0lax">1000 mg/d</td> <td class="tg-0lax">3000 mg</td> <td class="tg-0lax">0.8-36 μg/mL (6-279 μmol/L)</td> </tr> <tr> <td class="tg-0lax">Zonisamide</td> <td class="tg-0lax">Zonegran</td> <td class="tg-0lax">100-200 mg/d</td> <td class="tg-0lax">600 mg</td> <td class="tg-0lax">10-40 μg/mL (47-188 μmol/L)</td> </tr> </table></html> Abbreviations: IM, intramuscular; LD, loading does; MHD, 10-monohydroxy-derivative; PO, orally; VPA, valproic acid. Data from Patsalos et al, Halford and Lapointe, Cada et al, Sabril [package insert], Onfi [package insert], and Potiga [package insert]. Reproduced with permission from Rogers SJ, Cavazos JE. Rogers S.J., Cavazos J.E. Epilepsy. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. DiPiro J.T., Talbert R.L., Yee G.C., Matzke G.R., Wells B.G., Posey L eds. Pharmacotherapy: A Pathophysiologic Approach, 9e. New York: neurolists/aed_dosing_and_target_serum_concentration.txt Last modified: 2020/02/16 14:29by icna Log In