Version May 2024
| Days | Dose |
| Corticotropin injection gel* | |
| 1 to 14 | 75 units/m2 IM twice daily |
| 15 to 17 | 30 units/m2 IM in the morning |
| 18 to 20 | 15 units/m2 IM in the morning |
| 21 to 23 | 10 units/m2 IM in the morning |
| 24 to 29 | 10 units/m2 IM every other morning (3 total doses) |
| Prednisolone | |
| 1 to 14 | 10 mg oral 4 times daily¶Δ |
| 15 to 19 | 10 mg oral 3 times daily¶ |
| 20 to 24 | 10 mg oral 2 times daily |
| 25 to 29 | 10 mg oral daily |
| VigabatrinΔ◊ | |
| 1 to 3 | 50 mg/kg per day orally in two divided doses |
| 4 to 6 | 100 mg/kg per day orally in two divided doses |
| >7 | 150 mg/kg per day orally in two divided doses |
PERC: Pediatric Epilepsy Research Consortium; ACTH: adrenocorticotropic hormone; IM: intramuscular.
* Corticotropin injection gel (80 units/mL) is also known as ACTH and Acthar. Optimal dose is not established; however, most centers utilize the high-dose protocol listed in this table.
¶ If there is no clinical response after day 7 (ie, no 24-hour period free of infantile spasms), the dose can be increased to 20 mg 3 times daily. If done, the taper schedule from days 15 to 19 would be 10 mg 4 times daily, then proceeding as in the table beginning on day 20.
Δ If no clinical response by day 14, consider alternative treatment.
◊ Side effects (eg, sedation, hypotonia) may necessitate slower titration. The optimal treatment duration is unknown. Patients who respond to therapy can be continued on the drug for six months or longer.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
