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The determination of optimal dosage requires individual titration. Start therapy at a low dosage and increase gradually until optimum effect is achieved (usually between 40 to 80 mg daily). Administer with milk or food to avoid GI upset.
The following dosage titration schedule is suggested: 5 mg three times a day for first 3 days, 10 mg three times a day for the next 3 days, 15 mg three times a day for the third 3 days, 20 mg three times a day for the next 3 days. Thereafter additional increases may be necessary but the total daily dose should not exceed a maximum of 80 mg daily (20 mg four times a day).
The lowest dose compatible with an optimal response is recommended. If benefits are not evident after a reasonable trial period, patients should be slowly withdrawn from the drug.
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