Review Article

The Use of Ketogenic Diet in Pediatric Patients with Epilepsy

Table 3

Carbohydrate content in pediatric antiepileptic medications and daily total carbohydrate estimates for a five-year-old child (weighing 18 kg) on maximum monotherapy of antiepileptic drugs treatment doses (concerns for the patient on a ketogenic diet) [5] a . Medications with high carbohydrate content (≥2 g per dose) are highlighted in bold.

Antiepileptic medicationDosage unitGrams carbohydrate per dosage unitMaximum daily dose for an 18 kg 5-year-old childDaily carbohydrate total from maximum dosing of medication for a 18 kg 5-year-old child (grams)

Carbamazepine suspension (TEGretol)100 mg/5 mL2.6535 mg/kg/day16.7
Carbamazepine chewable tablets (TEGretol)100 mg0.2835 mg/kg/day1.8
Carbamazepine tablets (TEGretol)200 mg0.0635 mg/kg/day0.2
ClonazePAM tablets (KlonoPIN)2 mg0.140.2 mg/kg/day0.3
Ethosuximide syrup (Zarontin)250 mg/5 mL3.631.5 g/day21.8
Ethosuximide capsules (Zarontin)250 mg0.131.5 g/day0.78
Felbamate solution (Felbatol)600 mg/5 mL1.545 mg/kg/day2
Felbamate tablets (Felbatol)400 mg0.1345 mg/kg/day0.3
Felbamate tablets (Felbatol)600 mg0.1945 mg/kg/day0.3
Gabapentin tablets (Neurontin)100 mg0.0340 mg/kg/day0.2
Gabapentin tablets (Neurontin)300 mg0.0740 mg/kg/day0.2
Gabapentin tablets (Neurontin)400 mg0.140 mg/kg/day0.2
LamoTRIgine tablets (LaMICtal)25 mg0.0310 mg/kg/day0.2
LamoTRIgine tablets (LaMICtal)100 mg0.1110 mg/kg/day0.2
LamoTRIgine tablets (LaMICtal)150 mg0.1610 mg/kg/day0.2
LamoTRIgine tablets (LaMICtal)200 mg0.1410 mg/kg/day0.1
LamoTRIgine chewable/dispersible tablets (LaMICtal)5 mg, 25 mg010 mg/kg/day0
Levetiracetam oral solution (Keppra)100 mg/mL0.310 mg/kg/day0.5
Phenobarbital elixir   * 0.71 g ethyl alcohol/5 mL20 mg/5 mL3.45 mg/kg/day15.3
Phenobarbital tablets15 mg0.065 mg/kg/day0.4
Phenobarbital tablets30 mg0.075 mg/kg/day0.2
Phenobarbital tablets60 mg0.15 mg/kg/day0.2
Phenytoin suspension (Dilantin)125 mg/5 mL1.398 mg/kg/day1.6
Phenytoin infatabs (Dilantin)50 mg0.488 mg/kg/day1.4
Phenytoin kapseal (Dilantin)30 mg0.158 mg/kg/day0.7
Phenytoin kapseal (Dilantin)100 mg0.118 mg/kg/day0.2
Primidone oral suspension (Mysoline)250 mg/5 mL025 mg/kg/day0
Primidone tablets (Mysoline)50 mg0.0325 mg/kg/day0.27
Primidone tablets (Mysoline)250 mg0.0325 mg/kg/day0.1
Sodium divalproex sprinkle capsules (Depakote)125 mg0.0560 mg/kg/day0.4
Sodium divalproex tablets (Depakote)125 mg0.0360 mg/kg/day0.3
Sodium divalproex tablets (Depakote)250 mg0.0560 mg/kg/day0.2
Sodium divalproex tablets (Depakote)500 mg0.160 mg/kg/day0.2
Topiramate tablets (Topamax)25 mg0.049 mg/kg/day0.3
Topiramate tablets (Topamax)100 mg0.179 mg/kg/day0.3
Topiramate tablets (Topamax)200 mg0.099 mg/kg/day0.1
Valproic acid syrup (Depakene)250 mg/5 mL4.560 mg/kg/day19.4
Valproic acid capsules (Depakene)250 mg060 mg/kg/day0

aFor a five-year-old child weighing 18 kg, the maximum recommended carbohydrate amount is 21 g per day for the 3 : 1 classic ketogenic diet.