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Last updated: 26 November 2022

AED dosing and target serum concentration

Information
Anti-epileptic drugs
AED dosing and target serum concentration
DrugInitial or Starting DoseUsual Range or Maximum DoseComments Target Serum Concentration Range
Barbiturates   
Phenobarbital1-3 mg/kg/d (10-20 mg/kg LD)180-300 mg10-40 μg/mL (43-172 μmol/L)
Primidone100-125 mg/d750-2000 mg5-10 μg/mL (23-46 μmol/L)
Benzodiazepines   
Clobazam≤30 kg 5 mg/d; >30 kg 10 mg/d≤30 kg up to 20 mg; > 30 kg up to 40 mg0.03-0.3 ng/mL (0.1-1.0 nmol/L)
Clonazepam1.5 mg/d 20 mg 20-70 ng/mL (0.06-0.22 μmol/L)
DiazepamPO: 4-40 mgPO: 4-40 mg100-1000 ng/mL (0.4-3.5 μmol/L)
IV: 5-10 mgIV: 5-30 mg
LorazepamPO: 2-6 mgPO: 10 mg10-30 ng/mL (31-93 nmol/L)
IV: 0.05 mg/kgIV: 0.05 mg/kg
IM: 0.05 mg/kg
Hydantoin   
PhenytoinPO: 3-5 mg/kg (200-400 mg)PO: 500-600 mgTotal: 10-20 μg/mL (40-79 μmol/L)
(15-20mg/kg LD)Unbound: 0.5-3 μg/mL (2-12 μmol/L)
Succinimide   
Ethosuximide500 mg/d500-2000 mg40-100 μg/mL (282-708 μmol/L)
Other   
Carbamazepine400 mg/d400-2400 mg4-12 μg/mL (17-51 μmol/L)
Ezoqabine300 mg/d1200 mgNot defined
Felbamate1200 mg/d3600 mg30-60 μg/mL (126-252 μmol/L)
Gabapentin300-900 mg/d4800 mg2-20 μg/mL (12-117 μmol/L)
Lacosamide100 mg/d400 mgNot defined
Lamotrigine25 mg every other day if on VPA; 25-50 mg/d if not on VPA100-150 mg if on VPA; 300-500 mg if not on VPA4-20 μg/mL (16-78 μmol/L)
Levetiracetam500-1000 mg/d3000-4000 mg12-46 μg/mL (70-270 μmol/L)
Oxcarbazepine300-600 mg/d2400-3000 mg3-35 μg/mL (MHD) (12-139 μmol/L)
Pregabalin150 mg/d600 mgNot defined
Rufinamide400-800 mg/d3200 mgNot defined
Tiagabine4-8 mg/d80 mg0.02-0.2 μg/mL (0.05-0.5 μmol/L)
Topiramate25-50 mg/d200-1000 mg5-20 mcg/mL (15-59 μmol/L)
Valproic acid15 mg/kg (500-1000 mg)60 mg/kg (3000-5000 mg)50-100 μg/mL (347-693 μmol/L)
Vigabatrin1000 mg/d3000 mg0.8-36 μg/mL (6-279 μmol/L)
Zonisamide100-200 mg/d600 mg10-40 μg/mL (47-188 μmol/L)

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:

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