Dosing & Administration
Adult Dose
10-15 mg/kg/day PO initially. Target serum level 50-100 mcg/mL.
Pediatric Dose
10-15 mg/kg/day PO initially.
Renal Adjustment
No adjustment necessary.
Hepatic Adjustment
Contraindicated in severe hepatic impairment.
Safety & Special Populations
Pregnancy Category
D (X for migraine prophylaxis) - High risk of neural tube defects.
Lactation Safety
Compatible.
Contraindications & Adverse Effects
Contraindications
- Hepatic disease
- Urea cycle disorders
- Mitochondrial disorders (POLG mutation)
Common Adverse Effects
- Hepatotoxicity
- Pancreatitis
- Thrombocytopenia
- Weight gain
- Teratogenicity