Topic Index https://cnke.org/topics/anti-epileptic-drugs Sat, 14 Jun 2025 18:35:14 +0000 en-gb AED Choice in Epilepsy https://cnke.org/articles/23 https://cnke.org/articles/23 Choice Antiepileptic Drug (AED)medication in children       Seizure type/syndrome First Line Second Line Drugs to avoid Focal seizures CBZ,LTG,OXC,TPM,VPA CLB,GBP,LEV,PHT,TGB,ZON,PGN   Generalised Seizures       Absence ESM,LTG,VPA CLB,CLM,TPM CBZ,GBP,OXC,TGB,VGB GTC CBZ,LTG,VPA,TPM CLB,LEV,OXC,ZON TGB,VGB Myoclonic VPA,TPM LTG,CLB,CLM,LEV,Piracetam CBZ,GBP,OXC,TGB,VGB Tonic LTG,VPA CLB,CLM,LEV,TPM CBZ,OXC Atonic LTG,VPA LEV,TPM,CLB,CLM CBZ,OXC,PHT Childhood absence epilepsy ESM,LTG,VPA LEV,TOP CBZ,OXC,PHT,TGB,VGB Juvenile absence epilepsy LTG,VPA LEV,TPM CBZ,OXC,PHT,TGB,VGB Juvenile myoclonic epilepsy LTG,VPA CLB,CLM,TPM,LEV CBZ,OXC,PHT,TGB,VGB BECTS CBZ,LTG,OXC,VPA LEV,TPM   BCOS CBZ,LTG,OXC,VPA LEV,TPM   Infantile spasms VGB,Steroids CLB,CLM,VPA,TPM CBZ,OXC Dravets VPA,TPM,CLB,CLM LEV,Stiripentol CBZ,LTG,OXC,VGB Lennox-Gastuat Syndrome VPA,LTG,TPM CLB,CLM,ESM,LEV,RUF CBZ,OXC Landau-Kleffner syndrome Steroids,LTG,VPA LEV,TPM CBZ,OXC CSWS Steroids,CLB,CLM,VPA,LTG,ESM LEV,TPM CBZ,OXC,VGB Myoclonic astatic epilepsy CLB,CLM,VPA,TPM LEV,LTG CBZ,OXC

ESM Ethosuximide
CLB Clobazam
CLM Clonazepam
GBP Gabapentin
LEV Levetiracetam
LTG Lamotrigine
OXC Oxcarbazepine
PGN Pregabalin
PHT Phenytoin
RUF Rufinamide
TGB Tiagabine
TPM Topiramate
VGB Vigabatrin
VPA Valproate
ZON Zonisamide

]]> Articles Sun, 29 Dec 2024 22:34:22 +0000 AED dosing and target serum concentration https://cnke.org/articles/22 https://cnke.org/articles/22
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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