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Carbatrol®
 

Dosing and titration

Many people (especially children) need to take prompt-release carbamazepine in three or four doses a day. Carbatrol, as an extended-release form, is more convenient and may be particularly helpful for patients who have trouble with compliance and for those whose blood levels fluctuate widely throughout the day.

Rashes that may be more serious are more likely to occur in persons with a particular gene called “HLA-B*1502”. This gene occurs almost exclusively in patients with ancestry across broad areas of Asia, including South Asian Indians. Patients with ancestry from these areas should have a blood test to see if they have the “HLA-B*1502” gene before starting treatment. Further Information for Healthcare Professionals Related to this Topic:
http://www.fda.gov/cder/drug/InfoSheets/HCP/carbamazepineHCP.htm

In general, carbamazepine should be started at 100-200 mg per day and titrated by increments of 100-200 mg every week or two as clinically needed. The average maintenance dose as monotherapy for adults is 600-1200 mg per day.

Seniors should be started at 100 mg/d and may require a lower maintenance dose, reached by small increments.

In children over 6, the usual maintenance dose is 15-30 mg/kg per day. The dosage may need to be increased within a month of initiation due to autoinduction. (See Clinical pharmacology.) Carbatrol's use as a sprinkle formulation is convenient, but taking less than the complete contents of the capsule is not recommended.