Peel back foil from the side to expose the tablet. The dose may be adjusted at intervals of 24 hours or greater, in increments of 0.5 mg or 1 mg per day, as tolerated, to a recommended dose of 3 mg per day. The recommended starting dose is 2 mg. Because the effect of Zanaflex peaks at approximately 1 to 2 hours post-dose and dissipates between 3 to 6 hours post-dose, treatment can be repeated at 6 to 8 hour intervals, as needed, to a maximum of three doses in 24 hours. Not to exceed 36 mg/day; single doses >16 mg not studied. DO NOT push the tablet through the foil because this could damage the tablet.The child-resistant pouch should be torn open at the notch to access the blister. We comply with the HONcode standard for trustworthy health information - Select one or more newsletters to continue. May increase to dosages above 1.5 mg twice daily at intervals of one week or longer.The initial dose is 0.5 mg once daily, administered as a single-daily dose in the morning or evening. For patients with body weight greater than or equal to 20 kg, initiate dosing at 0.5 mg per day. In these patients, during titration, the individual doses should be reduced. Doses higher than 6 mg per day have not been studied.Patients experiencing persistent somnolence may benefit from administering half the daily dose twice daily.While it is unknown how long a patient with schizophrenia should remain on RISPERDALAlthough there are no data to specifically address reinitiation of treatment, it is recommended that after an interval off RISPERDALThere are no systematically collected data to specifically address switching schizophrenic patients from other antipsychotics to RISPERDALThe initial dose range is 2 mg to 3 mg per day. Reinitiation of Treatment in Patients Previously DiscontinuedWe comply with the HONcode standard for trustworthy health information - After a minimum of four days, the dose may be increased to the recommended dose of 0.5 mg per day f… enzymeinducersqmetabolism and maypeffectiveness; dose adjustments may be necessary. Available for Android and iOS devices. Available for Android and iOS devices. The physician who elects to use RISPERDALPatients experiencing persistent somnolence may benefit from a once-daily dose administered at bedtime or administering half the daily dose twice daily, or a reduction of the dose.For patients with severe renal impairment (CLcr < 30 mL/min) or hepatic impairment (10–15 points on Child Pugh System), the initial starting dose is 0.5 mg twice daily. After a minimum of four days, the dose may be increased to the recommended dose of 0.5 mg per day for patients less than 20 kg and 1.0 mg per day for patients greater than or equal to 20 kg. If higher doses are required, individual doses rather than dosing frequency should be increased Zanaflex should be used with caution in patients with any hepatic impairment. Although efficacy has been demonstrated in studies of pediatric patients with bipolar mania at doses between 0.5 mg and 6 mg per day, no additional benefit was observed above 2.5 mg per day, and higher doses were associated with more adverse events. For patients with body weight greater than or equal to 20 kg, initiate dosing at 0.5 mg per day. Single doses greater than 16 mg have not been studied.Zanaflex should be used with caution in patients with renal insufficiency (creatinine clearance < 25 mL/min), as clearance is reduced by more than 50%. If higher doses are required, individual doses rather than dosing frequency should be increased. These pharmacokinetic differences may result in clinically significant differences when switching administration of tablet and capsules and when switching administration between the fed or fasted state.