TableofAntiEpilepticDrugs(AEDs)usedinthe

treatmentofEpilepsyinChildrenunder12.
IMPORTANTAllthetablesbelowareguidelinesonly,givingaveragedailydoseranges.
Treatmentwillgenerallystartwithsmallerdosesthatarethengraduallyincreased.
Themostappropriatedoseforanyindividualmaybefound,duringcarefulmonitoring,tobehigherorlowerthanaverage.
DrugslicensedinIrelandarelistedinalphabeticalorder.

Drug
(GenericName)

Availableas
(BrandName)

ACETAZOLAMIDE

Diamox:Tablets250mg

CARBAMAZEPINE

Tegretol:Tablets100mg,200mg,
400mg,Liquidsugarfree
100mg/5ml,Suppositories
125mg,250mg,
TegretolRetard:tablets200mg,
400mg

GericarbSRtablets:200mg,
400mg(notinterchangeable
withTegretolproducts)

Frisium:Tablets10mg

CLOBAZAM

Usualtotaldailydosage
Numberof
*Indicatesusualstarting Doses/Day
doseinmg/kg/day(mgof
AEDperkgofthechilds
weightperday)

5*
2
1020
Max:750mg/day(notper
kg)

Treatment

Possiblesideeffectsinclude

Maybeusedformenstrualrelated
seizures,certainepisodicdisorders
andtoenhancecertainotheranti
epilepticdrugse.g.
carbamazepine.

5*

1020

PRdoseisprescribed25%
higherthanPOdose.

2 4
(Sustained
release
preparations
giventwiceaday;
plaintabletsand
liquidgiven3
timesaday)

Effectiveagainstgeneralisedtonic
clonicandpartialseizures.
Ineffectiveagainstabsences.May
worsenmyoclonicandabsence
seizures

Lackofappetite,lossofweight,
drowsiness,depression,pinsand
needlesinhandsandfeet,jointpains,
increasedurineoutput,thirst,
headache,dizziness,fatigueand
irritability.

Skinrash,ifallergicto
carbamazepine.Blurredvision,
doublevision,unsteadinessand
nauseamayoccurinitiallyorifthe
doseistoohigh.Dizzinessand
headaches.

0.25*
0.5
Max:1mg/kg/dayor
30mg/day

Effectiveagainstgeneralisedtonic
clonicandpartialseizures,but
tolerancedevelopsinaboutone
thirdofchildren.

Drowsinessmayoccurbutthisdrugis
lesssedatingthanclonazepamor
diazepam.

CLONAZEPAM

Rivotril:Tablets0.5mg,2mg
ClonazepamSuspension0.5mg
in5mls(Unlicensedproduct)

25mcg/kg*
240mcg/kg/day
OR

Under12months:
500mcg1mg
15years:13mg
512years:36mg

10*
2040

2/3

Effectiveagainstgeneralisedtonic
clonicandpartialseizures,
absences,myoclonicseizures,
LennoxGastautsyndrome,
infantilespasmsandstatus
epilepticus.

ETHOSUXIMIDE

Zarontin:Syrup250mg/5ml

Neurontin:Capsules100mg,
300mg,400mg.Tablets600mg,
800mg

1015*
2550
Max:70mg/kg/day

3
(Twicedailyis
adequate)

LAMOTRIGINE

Lamictal:Tablets25mg,50mg,
100mg,200mg,Dispersible
tablets2mg,5mg,25mg,50mg,
100mg,200mg

Whentakenwith Sodium
Valproate:
0.15*
15
Maxsingledose:100mg.
Whentakenwithout
SodiumValproate:
0.6*
515
Maxsingledose:200mg

1 2
Complex
interactionswith
manyAEDssee
literaturefor
completedosing
information.

Effectiveagainstgeneralised
absencesandmaybeusedfor
epilepsieswithsimilarEEG
changestoabsences.

Recommendedinpartialseizures
whereprevioustreatmenthas
beenineffective.Maymake
myoclonicand/orabsence
seizuresworse.

Effectiveagainst partial,absence,
generalisedtonicclonicseizures
andLennoxGastautsyndrome.
Licensedforuseinchildrenover2
years.

GABAPENTIN

LEVETIRACETAM

Keppra:Tablets250mg,500mg,
1000mg,Oralsolution100mg/ml
,IVsolution100mg/ml

10*

1060

Drowsinessandsedationarequite
commonbutthesemaywearoff.
Tolerance(declineineffectiveness
withtime)tendstodevelop.
Increasedrespiratorytractsecretions.
Fatigue,
aggressionandoveractive
restlessness.

Nausea,headacheanddrowsiness.

Drowsiness,dizziness,headache,
fatigue,doublevision,unsteadiness
andshakymovements.

Skinrashparticularlyifrapiddose
increase,ifallergictolamotrigine,or
ifusedinconjunctionwithsodium
valproate.Drowsiness,doublevision,
dizziness,headacheandflulike
symptoms,ifdoseistoohigh.
Possiblyinsomnia.
Tremormayoccurwhenusedwith
sodiumvalproate.Thismayreduceif
eithermedicationisreduced.

Canbeusedinchildrenwith
Dizziness,GIupset,sedationand
partialorgeneralisedseizuresover behaviourchange.
4yearsofage.

NITRAZEPAM

Suspension:2.5mg/5ml
(Unlicensedproduct)

2/3

Infantilespasms.

Confusion,dependence,shaky
movements,muscleweaknessand
lossofmemory.

Trileptal:Tablets150mg,300mg,
600mg,OralSuspension
60mg/ml

0.25*
0.5
Max:1mg/kg/dayor
10mg/day

8 10*
1030
Max:46mg/kg/day

OXCARBAZEPINE

Partialandgeneralisedseizures.
Licensedforuseinchildrenover6
years

PHENOBARBITAL
(Phenobarbitone)

PhenobarbitalB.P:Tablets15mg,
30mg,60mg
PhenobarbitalElixir15mg/5ml
(Unlicensedproduct)

2 3*

58

1 2

Effectiveagainstgeneralisedtonic
clonicandpartialseizures.Status
epilepticus,neonatalseizures.

PHENYTOIN

Epanutin:Capsules25mg,50mg,
100mg,300mg,Chewable
Infatabs50mg,Suspension
30mg/5ml

Note:DifferentEpanutin
preparationscontainphenytoin
indifferentformsandareNOT
interchangeable.

3 5*
510

Usualmax:15mg/kg/day
OR300mg/day(notper
kg)
(Dosesvaryconsiderably
dependingonage)

Effectiveagainstgeneralisedtonic
clonicandpartialseizures.Status
epilepticus.Bloodtestingis
essentialwhenusingphenytoinas
relationshipbetweendoseand
bloodleveliscomplex.

PRIMIDONE

Mysoline:Tablets250mg

125mg(notperkg)*
2501500

Partialandgeneralisedtonic
clonicseizures.

Skinrashifallergictooxcarbazepine.
Doublevision,unsteadiness,
headache,nauseaandconfusion.

Drowsinessmayoccurinitially,
sedationandslowingofmental
performancemaypersist.Fatigue,
listlessness,tiredness,depression,
rash,insomniaandirritability.
Hyperactivity,aggressionandsubtle
impairmentofmemory,moodand
learningcapacity.

Skinrashifallergictophenytoin.
Drowsiness,unsteadinessandslurred
speechmayoccurifthedoseistoo
high.Coarseningoffacialfeatures,
overgrowthofgums,growthofexcess
hairandacnemaybeproblemswith
prolongedtherapy,ascansome
anaemias(treatedwithfolicacid).
Shakymovements,unsteadygait,
rapidinvoluntarymovementofthe
eyeandsedation.
Mayworsenmyoclonus.

Fatigue,listlessness,tiredness,
depression,psychosis,overactive
restlessnessandirritability.

RUFINAMIDE

Inovelon:Tablets100mg,
200mg,400mg(canbecrushed)

SODIUM
VALPROATE

Epilim:ECTablets200mg,
500mg,Crushabletablets
100mg,Liquidsugarfree
200mg/5ml,Syrup200mg/5ml
EpilimChrono:Tablets200mg,
300mg,500mg
EpilimChronospheres:100mg,
250mg,500mg,750mg,1000mg
sachets

TIAGABINE

Gabitril:Tablets5mg,10mg,
15mg

200mgs/day(not perkg)*

2003200mgs/day(not
perkg)
(Dependsonbodyweight
&whetherpatient
alreadyonsodium
valproate.
Seeliteraturefor
completedosing
information.)

1015*
2530
Upto60mg/kg/dayin
infantilespasms

2
or
Oncedaily
startingdoseif
onsodium
valproate.

Addontherapyforseizures
associatedwithLennoxGastaut
Syndromeinchildrenaged4yrs
andolder.

Headache,dizziness,fatigue,GIupset
(includingdyspepsia,abdominalpain,
constipation,diarrhoea),rhinitis,
sinusitis,influenza,pneumonia,
drowsiness,insomnia,anxiety.

2
(EpilimChrono
tabletsand
Chronospheres
aregivenoncea
day)

Effectiveagainstgeneralisedtonic
clonicandpartialseizuresand
absences.

GIdisturbance,hyperactivityand
behaviouralproblems.Diarrhoeahas
beenreportedwithuseof
Chronospheres.
Hairlossoccursinsomepeoplebut
notusuallysevereandusually
reversibleifthedoseisreduced.
Increasedappetitemaycauseweight
gain.Sodiumvalproatehasbeen
associatedwithincreasedincidence
ofpolycysticovariesandmenstrual
irregularities.Drowsinessandshaky
movementsareinfrequentside
effects.Liverdamageduetosodium
valproateisveryuncommon.

Dizziness,fatigue,anxiety, tremor,
concentrationdifficulties,depression
ofmood,agitationandjerkinessof
limbs.
Maymakemyoclonicseizuresworse.

10mg/day(notperkg)*
3
1530mg/day(notperkg)
(Notlicensedforchildren
under12yrsold)

Recommendedinpartialseizures
withorwithoutsecondary
generalisationwhenprevious
treatmenthasbeenineffective.

TOPIRAMATE

Topamax:Tablets25mg,50mg,
Asmonotherapy:
100mg,200mg,Sprinklecapsules 0.51*
15mg,25mg
36
Max:15mg/kg/day

Asadjunctivetherapy:
25mg/day(notperkg)*
59
Max:15mg/kg/day

Recommendedinpartialand
generalisedseizures.Severe
myoclonicepilepsyininfancy.
Forchildrenover4yearsold.

VIGABATRIN

Sabril:Tablets500mg,Sachets
500mg(sugarfree)

30 40*
6080
Max:150mg/kg/dayor3g
InfantileSpasmdose:
3050*
80100
Max:150/Kg/day

Canbeconsideredforresistant
partialseizuresifvisualfieldscan
bemonitored.
Firstlineforinfantilespasms.

ETHOSUXIMIDE

Zarontin:Syrup250mg/5ml

10*
2040

GABAPENTIN

Neurontin:Capsules100mg,
300mg,400mg.Tablets600mg,
800mg

1015*
2550
Max:70mg/kg/day

3
(Twicedailyis
adequate)

Effectiveagainstgeneralised
absencesandmaybeusedfor
epilepsieswithsimilarEEG
changestoabsences.

Recommendedinpartialseizures
whereprevioustreatmenthas
beenineffective.Maymake
myoclonicand/orabsence
seizuresworse.

Headache,drowsiness,dizzinesspins
andneedlesinhandsandfeet.
Reducedappetitemayresultin
weightloss.Increasedriskofkidney
stones.Slowingofmental
performanceandoflanguagemay
occurbutminimisedifdosestarted
lowandincreasedslowly.Acute
myopiawithsecondaryangleclosure
glaucomaisrare(occurswithin1
monthofstartingtreatment).

Drowsiness,nausea,behaviourand
moodchanges.Psychoticreactions
havebeenreported.Visualfield
defectshavebeenreportedinonein
threeadultstakingvigabatrininthe
longterm.Visualfieldsshouldbe
measuredeverysixmonthswhile
takingvigabatrin.
Mayworsenabsencesandmyoclonic
seizures.

Nausea,headacheanddrowsiness.

Drowsiness,dizziness,headache,
fatigue,doublevision,unsteadiness
andshakymovements.

LAMOTRIGINE

Lamictal:Tablets25mg,50mg,
100mg,200mg,Dispersible
tablets2mg,5mg,25mg,50mg,
100mg,200mg

Whentakenwith Sodium
Valproate:
0.15*
15
Maxsingledose:100mg.
Whentakenwithout
SodiumValproate:
0.6*
515
Maxsingledose:200mg

1 2
Complex
interactionswith
manyAEDssee
literaturefor
completedosing
information.

LEVETIRACETAM

Keppra:Tablets250mg,500mg,
1000mg,Oralsolution100mg/ml
,IVsolution100mg/ml

10*

1060

NITRAZEPAM

Suspension:2.5mg/5ml
(Unlicensedproduct)

2/3

OXCARBAZEPINE

Trileptal:Tablets150mg,300mg,
600mg,OralSuspension
60mg/ml

0.25*
0.5
Max:1mg/kg/dayor
10mg/day
8 10*
1030
Max:46mg/kg/day

Effectiveagainstpartial,absence,
generalisedtonicclonicseizures
andLennoxGastautsyndrome.
Licensedforuseinchildrenover2
years.

Skinrashparticularlyifrapiddose
increase,ifallergictolamotrigine,or
ifusedinconjunctionwithsodium
valproate.Drowsiness,doublevision,
dizziness,headacheandflulike
symptoms,ifdoseistoohigh.
Possiblyinsomnia.
Tremormayoccurwhenusedwith
sodiumvalproate.Thismayreduceif
eithermedicationisreduced.

Canbeusedinchildrenwith
Dizziness,GIupset,sedationand
partialorgeneralisedseizuresover behaviourchange.
4yearsofage.

Infantilespasms.
Confusion,dependence,shaky
movements,muscleweaknessand
lossofmemory.
Partialandgeneralisedseizures.
Licensedforuseinchildrenover6
years

Skinrashifallergictooxcarbazepine.
Doublevision,unsteadiness,
headache,nauseaandconfusion.

TableII:EmergencyDrugTreatment
Drug
(GenericName)

DIAZEPAM

BUCCALMIDAZOLAM

Availableas
(BrandName)

Dose

Treatment

Possiblesideeffects

Stesolid:rectaltubes5mg,
10mg
DiazepamRectubes:2.5mg
(Unlicensedproduct)

Epistatus10mg/ml
(Unlicensedproduct)

0.5mg/kgOR
1month2years:5mg
212years:10mg

Foremergencyuseonlyin
statusepilepticusorprolonged
seizureactivity

Drowsiness,unsteadiness,blurredvision,
amnesiaandvertigo.

0.25mg/kg
Maxdose10mg
OR
612months:2.5mg
14years:5mg
59years:7.5mg
10yearsandover:10mg

Foremergencyuseonlyin
statusepilepticusorprolonged
seizureactivity

Drowsiness,unsteadiness,blurredvision,
amnesiaandvertigo.