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Suggest Dosage Of Epilex For Child
Question: Epilex maximum dose for a 4 years old kid whose weight is 15 kg?
Brief Answer:
Should not go beyond 600 mg per day
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I have been through your kid's detailed medical history provided by you.
Your question is straightforward and so here is the answer:
Though the theoretical dose range for epilex(valproate) is 20-60 mg per kg body weight per day.But,due to risk of side effects,we in clinics usually don't go beyond 40mg per kg body wt.per day.
Your kid is 15 kg,so the starting dose is 20 times 15,and that is 300 mg per day and maximum is 40 times 15 and that is 600 mg per day.
If you have follow up questions,please feel free to ask.
Dr.Ajay Panwar,
MD,DM(Neurology)
Should not go beyond 600 mg per day
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I have been through your kid's detailed medical history provided by you.
Your question is straightforward and so here is the answer:
Though the theoretical dose range for epilex(valproate) is 20-60 mg per kg body weight per day.But,due to risk of side effects,we in clinics usually don't go beyond 40mg per kg body wt.per day.
Your kid is 15 kg,so the starting dose is 20 times 15,and that is 300 mg per day and maximum is 40 times 15 and that is 600 mg per day.
If you have follow up questions,please feel free to ask.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Panwar,
Thanks a lot for your reply. You have already answered my question. However, just to double check, the range you mentioned (20 - 60 mg per kg per day) is that applicable to kids who is taking another anti epileptic medicine (levipil)? I assumed that the dose might be different for kid and for adult.
My daughter is taking this medicine for little longer than 7 weeks. For first four weeks she took 300 mg per day but still those small seizures were not under controlled. So, her nurologist decided to increase the dose 480 mg per day from 4th - 6th weeks and from 7th weeks onward 560 mg. So, for last three days she is in this dose (560 mg per day) and her seizures are still in same condition (she will have small seizures (lasts for 2-5 seconds) 5-10 times per day). Her appetite reduced a lot, almost she is not taking any solid food, all the time she is energy less, drowsee. after taking good sleep (around 7 hours), she will be only active for 2-3 hours. Are those normal? Are those because of medicine side effects or something else might be there?
She did not have any seizures for last 3 years and her doctor was thinking of stopping the medicine slowly. Suddenly this small seizure started, what might be the reason for that, do you have any idea?
Thanks a lot for your reply. You have already answered my question. However, just to double check, the range you mentioned (20 - 60 mg per kg per day) is that applicable to kids who is taking another anti epileptic medicine (levipil)? I assumed that the dose might be different for kid and for adult.
My daughter is taking this medicine for little longer than 7 weeks. For first four weeks she took 300 mg per day but still those small seizures were not under controlled. So, her nurologist decided to increase the dose 480 mg per day from 4th - 6th weeks and from 7th weeks onward 560 mg. So, for last three days she is in this dose (560 mg per day) and her seizures are still in same condition (she will have small seizures (lasts for 2-5 seconds) 5-10 times per day). Her appetite reduced a lot, almost she is not taking any solid food, all the time she is energy less, drowsee. after taking good sleep (around 7 hours), she will be only active for 2-3 hours. Are those normal? Are those because of medicine side effects or something else might be there?
She did not have any seizures for last 3 years and her doctor was thinking of stopping the medicine slowly. Suddenly this small seizure started, what might be the reason for that, do you have any idea?
Brief Answer:
Dose is in mg per kg body weight for children as well as adults.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and providing further details.
To reiterate,dose is 20-60 mg/kg body weight per day for adults as well as kids.Since,it is per kg body weight,it automatically becomes different for kids as they are low in weight.
Actually,according to protocol treatment,patient is to be taken to the highest optimal dose of an anti-convulsant and even if then seizures are not controlled,then another drug is added and then its dose should be taken to the highest optimal dose.
One liner about management is-
Seizures to be controlled on either one drug with maximum dose,or two drugs in their maximum doses or three drugs in their maximum doses.It is wrong practice to run a patient on 2 or 3 drugs in their minimal doses.
Your neurologist had the correct approach in starting epilex first with basic doses and then gradually building up.Excessive drowsiness is a common side effect of valproate.It may also cause appetite loss.
Myoclonic seizures are not controlled on levipil and even on adding valproate in its highest doses.So,probably they are unresponsive to valproate and levipil combination.
I am afraid to say that if that is the case,then these myoclonic seizures are unresponsive to two of the best first line drugs for myoclonic seizures.
At this point,it is difficult for me to say that why all of a sudden these myoclonic jerks started.If you can please take a video of the kid having these jerks and share it on google drive(while posting the link here in follow-up),I shall probably be able to have a clear picture and make a comment.Along with,please upload Electroencephalogram(EEG) report,and other medical documents.
Waiting for your follow-up question.
Dr.Ajay Panwar,
MD,DM(Neurology)
Dose is in mg per kg body weight for children as well as adults.
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and providing further details.
To reiterate,dose is 20-60 mg/kg body weight per day for adults as well as kids.Since,it is per kg body weight,it automatically becomes different for kids as they are low in weight.
Actually,according to protocol treatment,patient is to be taken to the highest optimal dose of an anti-convulsant and even if then seizures are not controlled,then another drug is added and then its dose should be taken to the highest optimal dose.
One liner about management is-
Seizures to be controlled on either one drug with maximum dose,or two drugs in their maximum doses or three drugs in their maximum doses.It is wrong practice to run a patient on 2 or 3 drugs in their minimal doses.
Your neurologist had the correct approach in starting epilex first with basic doses and then gradually building up.Excessive drowsiness is a common side effect of valproate.It may also cause appetite loss.
Myoclonic seizures are not controlled on levipil and even on adding valproate in its highest doses.So,probably they are unresponsive to valproate and levipil combination.
I am afraid to say that if that is the case,then these myoclonic seizures are unresponsive to two of the best first line drugs for myoclonic seizures.
At this point,it is difficult for me to say that why all of a sudden these myoclonic jerks started.If you can please take a video of the kid having these jerks and share it on google drive(while posting the link here in follow-up),I shall probably be able to have a clear picture and make a comment.Along with,please upload Electroencephalogram(EEG) report,and other medical documents.
Waiting for your follow-up question.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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