In patients with renal impairment (creatinine clearance <30 mL/min), TRILEPTAL® should be initiated at one half the usual dosage and increased slowly.
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When TRILEPTAL is used as add-on therapy at dosages >1200 mg/day, a decrease in the dose of phenytoin may be required.
Children aged 2 to <4 years may require up to twice the TRILEPTAL dose per body weight compared with adults; and children aged 4 to ≤12 years may require a 50% higher TRILEPTAL dose per body weight compared with adults‡
A lower starting dosage and slower titration may be considered for some patients as clinically indicated
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Children aged 2 to <4 years have an increased clearance (80%) of MHD (active metabolite of TRILEPTAL) compared with adults. Children aged 4 to 12 years have an increased clearance (40%) of MHD compared with adults. As weight increases, for children ≥13 years of age, MHD clearance is expected to reach that of adults.
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