Trokendi XR

Adult Dosing .

Dosage forms:  ER CAP: 25 mg, 50 mg, 100 mg, 200 mg

partial seizures

[monotherapy]

Dose: 400 mg PO qd; Start: 50 mg PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg PO qd, then incr. by 100 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

[adjunct tx]

Dose: 200-400 mg PO qd; Start: 25-50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: doses >400 mg/day rarely more effective, may incr. ADR risk; do not open cap; taper dose gradually to D/C

seizures, primary generalized tonic clonic

[monotherapy]

Dose: 400 mg PO qd; Start: 50 mg PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg PO qd, then incr. by 100 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

[adjunct tx]

Dose: 400 mg PO qd; Start: 25-50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

seizures, Lennox-Gastaut syndrome

[adjunct tx]

Dose: 200-400 mg PO qd; Start: 25-50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

migraine prophylaxis

[100 mg PO qd]

Start: 25 mg PO qd x1wk, then incr. by 25 mg/day qwk; Max: 200 mg/day; Info: do not open cap; taper dose gradually to D/C

cyclic vomiting syndrome prophylaxis, moderate-severe (off-label)

[100 mg PO qd]

Start: 25 mg PO qd, incr. by 25 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

renal dosing

[adjust dose amount]

CrCl <70: decr. usual dose by 50%

HD: decr. usual dose, amount not defined, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  ER CAP: 25 mg, 50 mg, 100 mg, 200 mg

partial seizures

[monotherapy, 6-9 yo, <11 kg]

Dose: 150-250 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 12-22 kg]

Dose: 200-300 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 23-31 kg]

Dose: 200-350 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 32-38 kg]

Dose: 250-350 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, >39 kg]

Dose: 250-400 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 10 yo and older]

Dose: 400 mg PO qd; Start: 50 mg PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg PO qd, then incr. by 100 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

[adjunct tx, 6-16 yo]

Dose: 5-9 mg/kg/dose PO qd; Start: 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open cap; taper dose gradually to D/C

seizures, primary generalized tonic clonic

[monotherapy, 6-9 yo, <11 kg]

Dose: 150-250 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 12-22 kg]

Dose: 200-300 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 23-31 kg]

Dose: 200-350 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, 32-38 kg]

Dose: 250-350 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 6-9 yo, >39 kg]

Dose: 250-400 mg PO qd; Start: 25 mg PO qhs x1wk, then 50 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: do not open cap; taper dose gradually to D/C

[monotherapy, 10 yo and older]

Dose: 400 mg PO qd; Start: 50 mg PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg PO qd, then incr. by 100 mg/day qwk; Info: do not open cap; taper dose gradually to D/C

[adjunct tx, 6-16 yo]

Dose: 5-9 mg/kg/dose PO qd; Start: 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open cap; taper dose gradually to D/C

seizures, Lennox-Gastaut syndrome

[adjunct tx, 6-16 yo]

Dose: 5-9 mg/kg/dose PO qd; Start: 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open cap; taper dose gradually to D/C

migraine prophylaxis

[12 yo and older]

Dose: 100 mg PO qd; Start: 25 mg PO qd x1wk, then incr. by 25 mg/day qwk; Max: 200 mg/day; Info: do not open cap; taper dose gradually to D/C

renal dosing

[adjust dose amount]

CrCl <70: decr. usual dose by 50%

HD: decr. usual dose, amount not defined, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised