Antiepileptic Drugs - Table 1
Suggested daily dosage, Common and Severe Adverse Effects of Antiepileptic Drugs in Children.
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Usual dose (oral)
mg/kg/day
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Common Adverse Effects
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Severe Adverse Effects
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First Generation Antiepileptic Drugs
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Carbamazepine
(Tegretol®)
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10-20
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Ataxia, diplopia, rash
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Aplastic anemia, agranulocitosis, SJS/TEN, liver toxicity, pancreatitis, SLE
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Clobazam
(Frisium®)
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0.5-1 (maximum 30 mg/day)
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Sedation
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No
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Clonazepam
(Rivotril®)
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0.1-0.2
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Fatigue, drowsiness, hypotonia, behaviour disturbances, salivary and bronchial hypersecretion
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Respiratory depression (only IV route)
|
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Ethosuximide
(Zarontin®)
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20-30
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Gastric discomfort, hiccups, rash, blurred vision, headache
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Aplastic anemia, agranulocitosis, SJS/TEN, liver toxicity, SLE
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Phenobarbital
(Luminale®)
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15-20 IV in newborns;
3-5 < 5 years;
2-3 > 5 years
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Behaviour disturbances, drowsiness, rash, cognitive impairment
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Agranulocitosis, SJS/TEN, liver toxicity, SLE
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Nitrazepam
(®)
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0.25-2-50
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Hypotonia, drowsiness, drooling
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Drooling and aspiration causing pneumonia
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Phenytoin
(Dintoina®)
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15-20 IV in newborns;
8-10 < 3 years;
4-7 > 3 years
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Ataxia, diplopia, nystagmus, acne, gurn hypetrophy, hirsutism, cognitive and sedative effects, peripheral neuropathy
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Megaloblastic anemia, lymphoma, agranulocitosis, SJS/TEN, liver toxicity, SLE; encephalopathy, choreoathetosis
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Primidone
(Maliasin®)
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10-20
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Behaviour disturbances, drowsiness, rash, cognitive impairment
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Agranulocitosis, SJS/TEN, liver toxicity, SLE
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Sodium
Valproate
(Depakin®)
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15-40
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Nausea and epigastric pain, tremor, alopecia, weight gain, hyperammonemia
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SJS/TEN, liver toxicity, SLE, pancreatitis, encephalopathy
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Second Generation Antiepileptic Drugs
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Felbamate
(Taloxa®)
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15-45
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Somnolence, anorexia, gastric discomfort, nervousness
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Aplastic anemia, agranulocitosis, SJS/TEN, liver toxicity, pancreatitis, SLE
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Gabapentin
(Neurontin®)
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25-35
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Fatigue, weight gain
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SJS/TEN, liver toxicity, behavioural problem/hostility
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Lacosamide
(Vimpat®)
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200-400 (in adults)
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Dizziness, ataxia, diplopia, nausea, PR prolongation, first degree AV block, headache
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No
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Lamotrigine
(Lamicta®)
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5-15 (add-on enzyme inducers);
1-3 (add-on VPA);
1-5 (add-on VPA + inducer)
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Dizziness, diplopia, ataxia, somnolence, rash
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Aplastic anemia, SJS/TEN, liver toxicity, pancreatitis, Lyell’s syndrome
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Levetiracetam
(Keppra®)
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20-40
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Somnolence, asthenia, headache, anorexia
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Psychotic events, liver toxicity, pancreatitis
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Oxcarbazepine
(Tolep®)
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30-45
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Somnolence, headache, ataxia, vomiting, hyponatremia, rash
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SJS/TEN, liver toxicity
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Rufinamide
(Inovelon®)
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30-40
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Drowsiness, abdominal pain, weight loss, nervousness
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No
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Stiripentol
(Diacomit®)
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50
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Drowsiness, loss of appetite
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No
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Tiagabine
(Gabitril®)
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0.5-2
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Dizziness, abdominal pain, nervousness, difficulty with concentration
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SJS/TEN, non convulsive status epilepticus
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Topiramate
(Topamax®)
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4-6
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Weight loss, paraesthesia, emotional lability, difficulty concentrating and word finding, hypohidrosis
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SJS/TEN, liver toxicity, pancreatitis
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Vigabatrin
(Sabril®)
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20-80;
100-150 for infantile spasms
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Excitation, drowsiness, weigh gain
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Liver toxicity, pancreatitis, psychosis, visual field defects, encephalopathy
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Zonisamide
(Zonegran®)
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4-12
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Somnolence, dizziness, ataxia, abdominal discomfort, decreased spontaneity, rash, hypohidrosis
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Aplastic anemia, agranulocitosis, SJS/TEN, liver toxicity, psychiatric disorders
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Legend: SJS = Stevens-Johnson Syndrome; TEN = toxic epidermal necrolysis; SLE = Systemic Lupus Erythamatosus; IV = intravenous.