AED dosing and target serum concentration
| Drug | Brand Name | Initial or Starting Dose | Usual Range or Maximum Dose | Comments Target Serum Concentration Range |
|---|---|---|---|---|
| Barbiturates | ||||
| Phenobarbital | Various | 1-3 mg/kg/d (10-20 mg/kg LD) | 180-300 mg | 10-40 μg/mL (43-172 μmol/L) |
| Primidone | Mysoline | 100-125 mg/d | 750-2000 mg | 5-10 μg/mL (23-46 μmol/L) |
| Benzodiazepines | ||||
| Clobazam | Onfi | ≤30 kg 5 mg/d; >30 kg 10 mg/d | ≤30 kg up to 20 mg; > 30 kg up to 40 mg | 0.03-0.3 ng/mL (0.1-1.0 nmol/L) |
| 20 mg | 20-70 ng/mL (0.06-0.22 μmol/L) | |||
| Clonazepam | Klonopin | 1.5 mg/d | ||
| Diazepam | Valium | PO: 4-40 mg | PO: 4-40 mg | 100-1000 ng/mL (0.4-3.5 μmol/L) |
| IV: 5-10 mg | IV: 5-30 mg | |||
| Lorazepam | Ativan | PO: 2-6 mg | PO: 10 mg | 10-30 ng/mL (31-93 nmol/L) |
| IV: 0.05 mg/kg | IV: 0.05 mg/kg | |||
| IM: 0.05 mg/kg | ||||
| Hydantoin | ||||
| Phenytoin | Dilantin | PO: 3-5 mg/kg (200-400 mg) | PO: 500-600 mg | Total: 10-20 μg/mL (40-79 μmol/L) |
| (15-20mg/kg LD) | ||||
| Unbound: 0.5-3 μg/mL (2-12 μmol/L) | ||||
| Succinimide | ||||
| Ethosuximide | Zarontin | 500 mg/d | 500-2000 mg | 40-100 μg/mL (282-708 μmol/L) |
| Other | ||||
| Carbamazepine | Tegretol | 400 mg/d | 400-2400 mg | 4-12 μg/mL (17-51 μmol/L) |
| Ezoqabine | Potiga | 300 mg/d | 1200 mg | Not defined |
| Felbamate | Felbatol | 1200 mg/d | 3600 mg | 30-60 μg/mL (126-252 μmol/L) |
| Gabapentin | Neurontin | 300-900 mg/d | 4800 mg | 2-20 μg/mL (12-117 μmol/L) |
| Lacosamide | Vimpat | 100 mg/d | 400 mg | Not defined |
| Lamotrigine | Lamictal | 25 mg every other day if on VPA; 25-50 mg/d if not on VPA | 100-150 mg if on VPA; 300-500 mg if not on VPA | 4-20 μg/mL (16-78 μmol/L) |
| Levetiracetam | Keppra | 500-1000 mg/d | 3000-4000 mg | 12-46 μg/mL (70-270 μmol/L) |
| Keppra XR | ||||
| Oxcarbazepine | Trileptal | 300-600 mg/d | 2400-3000 mg | 3-35 μg/mL (MHD) (12-139 μmol/L) |
| Pregabalin | Lyrica | 150 mg/d | 600 mg | Not defined |
| Rufinamide | Banzel | 400-800 mg/d | 3200 mg | Not defined |
| Tiagabine | Gabitril | 4-8 mg/d | 80 mg | 0.02-0.2 μg/mL (0.05-0.5 μmol/L) |
| Topiramate | Topamax | 25-50 mg/d | 200-1000 mg | 5-20 mcg/mL (15-59 μmol/L) |
| Valproic acid | Depakene | 15 mg/kg (500-1000 mg) | 60 mg/kg (3000-5000 mg) | 50-100 μg/mL (347-693 μmol/L) |
| Depakene SR | ||||
| Depakote | ||||
| Depakote ER | ||||
| Depacon | ||||
| Vigabatrin | Sabril | 1000 mg/d | 3000 mg | 0.8-36 μg/mL (6-279 μmol/L) |
| Zonisamide | Zonegran | 100-200 mg/d | 600 mg | 10-40 μg/mL (47-188 μmol/L) |
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:
Discussion