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ORIGINALARTICLE
The Carbohydrate and Caloric Content
of Concomitant Medications for Children
with Epilepsy on the Ketogenic Diet
Denis Lebel, Caroline Morin, Micheline Laberge, Nathalie Achim and Lionel Carmant ABSTRACT: Background: The ketogenic diet for children with refractory epilepsy requires a strict
control of the amount of ingested carbohydrates. This can be altered by medication prescribed for the
epileptic syndrome or for intercurrent illnesses. The goal of this paper is to compile the carbohydrate and
caloric content of commonly used medications in this population. Methods: We compiled a list of
frequently used medications with the help of Canadian manufacturers and the Compendium of
Pharmaceuticals and Specialties. We also tested a worst case scenario calculation based on the weight
of the tablet. Results: We list the carbohydrate and caloric content of 790 medications studied. Our worst
case scenario gives an over-estimate in all cases, making adjustments based on this calculation in an
emergency setting safe. Conclusion: We propose this list as a tool for physicians, dietitians, nurses and
pharmacists. The list can easily be adjusted, based on local practices and reviewed periodically.
RÉSUMÉ: Le contenu en hydrates de carbone et en calories des médicaments concomitants chez les enfants
épileptiques suivant la diète cétogène. Introduction: La diète cétogène chez les enfants dont l’épilepsie est
résistante au traitement demande un contrôle strict de la quantité d’hydrates de carbone ingérée qui peut être
influencée par la médication prescrite pour le syndrome épileptique ou pour une maladie intercurrente. Le but de cet
article est de compiler le contenu en hydrates de carbone et en calories de médicaments d’usage courant dans cette
population. Méthodes: Nous avons compilé une liste des médicaments d’usage courant avec l’aide de manufacturiers
Canadiens et du Compendium des produits et spécialités pharmaceutiques. Nous avons également testé un calcul
basé sur le poids du comprimé qui tenait compte de la pire situation possible. Résultats: Nous avons dressé une liste
du contenu en hydrates de carbone et en calories de 790 médicaments. Notre calcul selon la pire situation surestime
dans tous les cas, ce qui assure la sécurité de l’ajustement basé sur ce calcul en situation d’urgence. Conclusions:
Nous proposons cette liste comme outil pour les médecins, les diététistes, les infirmières et les pharmaciens. La liste
peut facilement être ajustée selon les pratiques locales et révisée périodiquement.
The ketogenic diet is a form of treatment used in children, and we now realize that complete or even partial loss of ketosis can sometimes adults, with refractory epilepsies or with significant impair seizure control.7 Strict compliance with the diet is, adverse events secondary to the anticonvulsants.1,2 The first therefore, of foremost importance. Some animal models show an report on the diet came in 1911 and it was supported by a second increased seizure threshold during treatment with the diet.8 We report 10 years later3,4 but the diet became almost obsolete also know that ketone bodies are present in the blood and are following the release of new medications in the 1940s. Due to able to cross the blood brain barrier, to serve as the principal the partial efficacy of phenytoin, further efforts to improve the source of energy to the brain. However, electrophysiological diet were later introduced leading to better compliance and again studies do not indicate that decreased neuronal excitability is encouraging results.5 Once again, in the ’70s, the advent of new mediated by a direct effect of ketone bodies.9 Ketosis is medications particularly valproic acid, lessened the interest inthe diet.6 Over the past 10 years, because of its persistent efficacyin children with refractory and even more benign epilepsies,there has been increasing interest from families, clinicians and From the Department of Pharmacy (DL, CM, NA) and Pediatrics (ML, LC), Hôpital researchers to use the diet to a greater extent and to better Ste-Justine, University of Montreal, Montreal, QC Canada RECEIVED DECEMBER 14, 2000. ACCEPTED INFINALFORMJUNE 20, 2001.
Reprint requests to: Lionel Carmant, Hôpital Ste-Justine, Department of Pediatrics, Although its mechanisms of action are still not understood, Division of Neurology, 3175 Côte Ste-Catherine, Montreal, QC, Canada H3T1C5 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES established by the activation of fatty acid oxidation, secondary to The results of the worst case scenario calculations showed the lack of carbohydrate reserves induced by the starvation that we never underestimated the content of a tablet or capsule period and maintained by the high lipid/carbohydrate + protein ( Table 2). The tendency is actually to overestimate the content of the diet. The constituents of the diet are calculated to carbohydrate content of the drugs. For example, a Biaxin tablet, provide a ratio of lipids/proteins + carbohydrates of 3/1 to 4/1.
with 250 mg of active ingredient weighs 0,520g. When we Carbohydrates can only make up 20% of total calorie intake substract the active ingredient, we have 270 mg left. The worst in a diet already limited on calorie supply, compared to more case scenario assumes that all of this weight is made of than 50% in a normal diet. The diet is usually maintained for a carbohydrates. When we compare the results of the worst case minimum period of two to six months and, if associated with a scenario (1.08 kCal) to the data obtained from the manufacturer significant improvement, is pursued for at least two years.
(0.210 kCal), we found that the worse case scenario During this two-year period, infectious illnesses and other medical problems are common in a population of children withrefractory epilepsy often with an associated mental handicap.
DISCUSSION
Although syrups are usually contra-indicated due to their highcarbohydrate content in the form of sucrose, maltose, sorbitol, Carbohydrates and loss of ketosis.
mannitol, alcohol or starch, the “sugar free” label of drug tablets The ingestion of an excessive amount of carbohydrate in the does not guarantee that ketosis will not be affected. The “sugar diet stimulates the release of insulin, which stops the release of free” label is used primarily for diabetics and these tablets may free fatty acids from the fat deposits, thus depriving the liver of contain sorbitol, a carbohydrate which will not affect glycemia its substrate for the production of ketones.11,12 This could occur but mightl affect ketosis in the diet. The carbohydrate content of when a new medication is prescribed to a child on the ketogenic tablets, including anticonvulsants and other concomitant drugs, diet or when drugs are given to this child for an acute illness.
can be difficult to manage for the physicians, nurses and The control of the insulin release by glucose is important for pharmacists. Published material from the US has been reviewed patients on the ketogenic diet. Both a high basal serum glucose but cannot be used in Canada because the drug formulations are level and an elevated peak level can increase the magnitude of different in the US.10 The goal of this paper is to review the subsequent insulin release for several hours.12 This is a possible carbohydrate and calorie content of the drugs most commonly explanation for the prolonged loss of ketosis seen when patients used by children to help clinicians evaluate their antiketotic on the ketogenic diet ingest an excessive amount of carbohydrates. When this occurs, returning to ketosis may take24 hours or more, since the insulin response to subsequent carbohydrate or amino acid exposure with the next meals may be Between November 1998 and November 1999 we listed all greater. This “break” in ketosis often offsets seizure control. A drugs used on the neurology and intensive care wards that are short period (12 to 24 hours) of fasting may be necessary for a available in liquid form, especially anticonvulsants, antibiotics, quick return to the ketotic state, but seizure control might not be analgesics, antipyretic drugs, anti-inflammatory medications, regained.5 Clinicians should select, whenever it is possible, laxatives and vitamins. We also reviewed tablet and capsule medications that will not affect the ketogenic diet. If a drug with forms of anticonvulsants, antibiotics, and laxatives. T h e i r a significant number of calories provided by carbohydrates must monography was reviewed in the Compendium of be selected, the diet should be adjusted accordingly. The data that Pharmaceuticals and Specialties (CPS) and each company was has been published to help the clinician make these decisions are then contacted by mail to complete missing data about the drug’s either out of date or compiled in the United States.9 Canadian content of carbohydrates and their derivatives, as well as their clinicians now have a tool to help them select a formulation that calorie content. We sent a total of 894 requests for information.
is less likely to affect the diet. If this list fails to provide On 46 drugs we tested a worst case scenario formula to information needed by the clinician, the worst case scenario can evaluate the maximal carbohydrate content of a tablet or capsule.
be used to evaluate the caloric content of a drug. As it always We measured the weight of 10 tablets, subtracted the amount of overestimates the caloric content of a drug, we feel the table is active material in these tablets and then divided the result by the number of tablets weighed. We considered this number to Drug-diet interactions.
represent the maximal carbohydrate content of thepharmaceutical formulation in grams and extrapolated the One must also be aware of unfavorable interactions between energy content by multiplying the calculated number by 4 drugs and the diet. Initially, because of its broad spectrum of efficacy and also because it is a branched chain fatty acid,valproic acid was believed to be able to replace the diet with a lesser requirement of family training and teaching.6 This has not been the case. In fact, a number of significant interactions exist Thanks to the collaboration of most of the pharmaceutical between valproic acid and the diet. One of its metabolites, 2- companies, we were able to compile the data published in Table propylpentanoyl-CoA-(valproyl-CoA) has been implicated in the 1. This is, we believe, a useful tool for pharmacists, nurses and inhibition of mitochondrial fatty acid oxidation.12 Valproic acid physicians involved in the care of these children. The list of may also interfere with beta-oxidation of medium-chain fatty drugs can easily be increased based on local practices and acids.13 This may be due to a direct action of 2-n-propyl-4- pentenoic acid.13 Clinically, we have not found valproic acid to Volume 28, No. 4 – November 2001 THE CANADIAN JOURNAL OF NEUROLOGICALSCIENCES significantly interfere with ketogenesis in children on the diet but valproic acid may increase the risk of side effects in patients on 4. Wilder RM. The effect of ketonemia on the course of epilepsy.
the ketogenic diet.14 In younger children, we recommend the use 5. Livingston SL. Comprehensive Management of Epilepsy in Infants, of the capsule form of divalproex, available in the US under the Childhood and Adolescence. Springfield, IL: Charles C Thomas.
brand name of Depakote, because it contains far less carbohydrates than the liquid formulation. 15 6. Wheless JW. The ketogenic diet: fact or fiction. J Child Neurol Phenobarbital should be used with caution because serum 7. Huttenlocher PR. Ketonemia and seizures: metabolic and anti- concentration can increase as much as 100% over the baseline convulsant effects of two ketogenic diets in childhood epilepsy.
when the diet is started.16 Phenobarbital elimination is slowed down in acidotic state. Other anticonvulsant drugs that can 8. Bough KJ, Matthews PJ, Eagles DA. A ketogenic diet has different directly affect ketosis include drugs that can reduce insulin effects upon seizures induced by maximal electroshock and bypentylenetetrazole infusion. Epilepsy Res 2000;38:105-114.
release, such as phenytoin,1 7 and acetazolamide with high 9. Thio LL, Wong M, Yamada KA. Ketone bodies do not directly alter glucose concentrations.1 8 Other anticonvulsant drugs can excitatory or inhibitory hippocampal synaptic transmission.
increase insulin release like phenobarbital19 and acetazolamide with low glucose concentrations.18 Finally, one needs to be 10. Feldstein TJ. Carbohydrate and alcohol content of 200 oral liquid careful when using beta-blocking agents. Beta-blocking agents medications for use in patients receiving ketogenic diets.
Pediatrics 1996;97:506-511.
inhibit fatty acid and gluconeogenetic substrate release and 11. Tallian KB, Nahata MC, Tsao CY. Role of the ketogenic diet with reduce plasma glucagon levels.20 Patients on both beta-blocking intractable seizures. Ann Pharmacother 1998;32:349-361.
agents and a diet low in carbohydrates and protein, or those 12. McGarry JD. Glucose-fatty acid interactions in health and disease.
u n d e rgoing fasting, are potentially more susceptible to Am J Clin Nutr 1998;67(Suppl):500S-504S.
13. Li J, Norwood DL, Mao LF, Schulz H. Mitochondrial metabolism hypoglycemia with decreased capability of ketogenesis. Beta- of valproic acid. Biochemistry 1991;30:388-394.
blocking agents may also decrease the symptoms of 14. Bjorge SM, Baillie TA. Inhibition of medium-chain fatty acid beta- hypoglycemia. We therefore avoid such treatment when possible, oxidation in vitro by valproic acid and its unsaturated metabolite, especially during early stages of treatment.
2-n-propyl-4-pentenoic acid. Biochem Biophys Res Commun In conclusion, we believe the information compiled in the 15. Ballaban-Gil K, Callahan C, O’Dell C, et al. Complications of the tables represents a useful tool for the professionals involved in ketogenic diet. Epilepsia 1998;39:744-748.
ketogenic diet programs. We also want to reinforce the need to 16. Kinsman SL, Vining EPG, Quakey SA, Mellitis D, Freeman JM.
be aware of the many possible interactions between drugs Efficacy of the ketogenic diet for intractable seizure disorders: (anticonvulsants and others) and the mechanisms involved in the review of 58 cases. Epilepsia 1992;33:1132-1136.
17. Kizer JS, Vargas-Gordon M, Brendel K, Bressler R. The in vitro inhibition of insulin secretion by diphenylhydantoin. J Clin Invest1970;49:1942-1948.
REFERENCES
18. Boquist L, Backman AM, Stromberg C. Hyperglycemia produced in mice by administration of acetazolamide and diphenylhydantoin.
1. Freeman JM, Vining EP, Pillas DJ, et al. The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 19. Venkatesan N, Davidson MB, Simsolo RB, Kern PA. Phenobarbital 150 children. Pediatrics 1998;102:1358-1363.
treatment enhances insulin-mediated glucose metabolism and 2. Barboka CJ. Epilepsy in adults: results of treatment by ketogenic diet improves lipid metabolism in the diabetic rat. Metabolism in one hundred cases. Arch Neurol Psychiatr 1930;23:904-914.
3. Guelpa G, Marie A. La lutte contre l’épilepsie par la désintoxication 20. Karam JH. Reversible insulin resistance in noninsulin-dependent et par la rééducation alimentaire. Revue de Thérapie Medico- diabetes mellitus. Horm Metab Res 1996;28:440-444. LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Table 1: Caloric content of drugs, listed by generic names
Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Tylenol suspension liquid (grape) (McNeil) Tylenol suspension liquid (bubblegum) (McNeil) Acetaminophen-caffeine-codeine phosphate Acetaminophen-caffeine-codeine phosphate Acetaminophen-caffeine-codeine phosphate Aluminium + magnesium hydroxyde, 45 mg + 40 mg / Liquid Aluminium + magnesium hydroxyde, / Liquid Amiloride HCl/Hydrochlorothiazide, 5/50 mg / Tablet Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Amoxicillin + clavulanic acid, 50 + 12,5 mg/ml / Liquid Amoxicillin + potassium clavulanate, 25+6,25 mg/ml / Liquid Amoxicillin + potassium clavulanate, 250 mg + 125 mg / Tablet Amoxicillin + clavulanate de potassium, 500 mg + 125 mg / Tab Clavulin (SmithKline Beecham Pharma) ASA-Caffeine-Codeine phosphate, 1 tablet / Tablet Bacampicillin, chlorhydrate, 400 mg / Tablet Bacampicillin, chlorhydrate, 800 mg / Tablet LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Bismuth subsalicylate, 17,6 mg/ml / Liquid Calcium gluconate + glucoheptonate, 20 mg/ml / Liquid Calcium Stanley (Stanley Pharmaceuticals) Carbamazepine, 200 mg / Controled release tablet Carbamazepine, 200 mg / Controled release tablet Carbamazepine, 400 mg / Controled release tablet Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Ciprofloxacin, chlorhydrate, 100 mg/ml / Liquid Clindamycin, palmitate, 15 mg/ml / Liquid LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Demeclocycline, chlorhydrate, 150 mg / Tablet Demeclocycline, chlorhydrate, 300 mg / Tablet Desogestrel-ethinyl estradiol, 0,5 mg / Tablet Desogestrel-ethinyl estradiol, 1 mg / Capsule Desogestrel-ethinyl estradiol, 2 mg / Capsule Dextrometorphan, bromhydrate – pseudoephedrine – guaifenesin, Novahistex DM Expt Dcgt (Hoechst Marion Roussel) 2,60 Dextrometorphan, bromhydrate – pseudoephedrine, Novahistine DM Dcgt (Hoechst Marion Roussel) Dextrometorphan, bromhydrate – pseudoephedrine, Novahistex DM Dcgt (Hoechst Marion Roussel) Dextrometorphan, bromhydrate, 3 mg/ml / Liquid Dextrometorphan, bromhydrate, 3 mg/ml / Liquid Dextrometorphan, bromhydrate de – pseudoephedrine - guaifenesin, 1,5 mg-3 mg-10 mg /ml / Liquid Novahistine DM Expt Dcgt (Hoechst Marion Roussel)2,44 Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Dextrometorphan, bromhydrate, 1,5 mg/ml / Liquid Dimenhydrinate, 25 mg immediate + 50 mg slow release/Capsule Gravol (Carter Horner) Benadryl elixir (Wa r n e r- L a m b e r t ) Docusa, sodium + casanthranol, 100 mg + 30 mg / Capsule Docusate, sodium + sennosides, 50 mg + 8,6 mg / Tablet LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Docusate sodium syrup (Altas Laboratories) Erythromycin, estolate, 25 mg/ml / Liquid Erythromycin, estolate, 50 mg/ml / Liquid Erythromycin, estolate, 25 mg/ml / Liquid Erythromycin, estolate, 50 mg/ml / Liquid Erythromycin, stearate, 25 mg/ml / Liquid Erythromycin, stearate, 50 mg/ml / Liquid Erythromycin, succinate, 40 mg/ml / Liquid Erythromycin, succinate, 80 mg/ml / Liquid Erythromycin, succinate, 40 mg/ml / Liquid Erythromycin, succinate, 80 mg/ml / Liquid Erythromycine-sulfisoxazole, 40-120 mg/ml / Liquid Ferrous sulfate, 15 mg(element. iron)/ml / Liquid Ferrous sulfate, 15 mg(element. iron)/ml / Liquid Volume 28, No. 4 – November 2001 THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Ferrous sulfate, 6 mg(element. iron)/ml / Liquid Ferrous sulfate, 6 mg(element. iron)/ml / Liquid Novo-Flupam / Novo-Flupam SP.C. (Novopharm) 1,193 Novo-Flupam / Novo-Flupam SP.C. (Novopharm) 1,060 Grepafloxacin, chlorhydrate, 200 mg / Tablet Hydrochlorothiazide/methyldopa, 250/15 mg / Tablet Hydrochlorothiazide/methyldopa, 250/25 mg / Tablet LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Ibuprofen, 200 mg / Tablet (sugar coating) Ibuprofen, 300 mg / Tablet (sugar coating) Ibuprofen, 400 mg / Tablet (suger coating) Novo-Methacin / Novo-Methacin SP.C. (Novopharm) 0,887 Novo-Methacin / Novo-Methacin SP.C. (Novopharm) 1,458 Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Medroxyprogesterone acetate, 10 mg / Tablet Medroxyprogesterone acetate, 2,5 mg / Tablet Medroxyprogesterone acetate, 5 mg / Tablet Methotrimeprazine maleate, 25 mg / Tablet Methotrimeprazine maleate, 50 mg / Tablet Metoclopramide, chlorhydrate, 1 mg/ml / Liquid Metoclopramide, chlorhydrate, 10 mg / Tablet Metoclopramide, chlorhydrate, 5 mg / Tablet Mexiletine, chlorhydrate, 100 mg / Granules Mexiletine, chlorhydrate, 200 mg / Granules Mineral oil 78 % sugar free jelly, / Jelly Minocycline, chlorhydrate, 100 mg / Capsule Minocycline, chlorhydrate, 100 mg / Capsule Minocycline, chlorhydrate, 50 mg / Capsule Minocycline, chlorhydrate, 50 mg / Capsule Minocycline, chlorhydrate, 100 mg / Capsule Minocycline, chlorhydrate, 50 mg / Capsule LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Normethadone + ephedrine, 10 mg/ml / Liquid Mycostatin (Bristol-Myers Squibb Gr. Pharma) Nystatin, 100 000 UI/ml / sugar free Liquid Alti-orciprenalline (Altimed Pharmaceutical Co.) Pnenobarbital elixir USP(Stanley Pharmaceuticals) 3,78 Phenylephrine HCl - hydrocodone bitartrate - guaifenesin, Novahistex DH Expt (Hoechst Marion Roussel) Phenylephrine HCl - hydrocodone bitartrate, Volume 28, No. 4 – November 2001 THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Phenylephrine HCl - hydrocodone bitartrate, Pivmecillinam, chlorhydrate, 200 mg / Tablet Polyethylene glycol /electrolytes, / Liquid Polyethylen glycol /electrolytes, / Liquid Polyethylen glycol /electrolytes, / Liquid Polyethylen glycol /electrolytes, / Powder Propoxyphene, hydrochloride, 65 mg / Capsule Psyllium (hydrophilic mucilloid for oral suspension) orange - smooth texture “Sugar free”, / Powder LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Psyllium no flavor, no sugar, smooth texture, / Powder Sennosides, 119 mg /dose unit (70ml) / Liquid Ex-Lax extra-strong, sugar coated tablets (Novartis) 0,74 Sodium citrate + citric acid, 1 meq/ml / Liquid Sodium phosphates, 2,4g monobasic + 0,9g dibasic /5ml / Liquid Fleet Phospho-Soda (Johnson & Jonhson Merck) Sodium phosphates, 2,4g monobasic + 0,9g dibasic /5ml / Liquid Pms-phosphate solution (Pharmascience) Spironolactone / hydrochlorothiazide, 25/25 mg / Tablet Spironolactone / hydrochlorothiazide, 50/50 mg / Tablet Sulcrate Suspension Plus (Hoechst Marion Roussel) 1,04 Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICAL SCIENCES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Pms-sodium polystyren sulfonate (Pharmascience) 0,94 Tetracycline, chlorhydrate, 250 mg / Capsule Tetracycline, chlorhydrate, 250 mg / Capsule Triamterene / Hydrochlorothiazide, 50/25 mg / Tablet LE JOURNAL CANADIEN DES SCIENCES NEUROLOGIQUES Drug, concentration and presentation
Commercial name and company
Caloric content*
Caloric content*
– CH§ (Kcal)
– Total (Kcal)
Trimethoprim + sulfamethoxazole, 160/800 mg / Tablet Trimethoprim + sulfamethoxazole, 160/800 mg / Tablet Trimethoprim + sulfamethoxazole, 160/800 mg / Tablet Trimethoprim + sulfamethoxazole, 160/800 mg / Tablet Trimethoprim + sulfamethoxazole, 160/800 mg / Tablet Trimethoprim + sulfamethoxazole, 20/100 mg / Tablet ped.
Trimethoprim + sulfamethoxazole, 8/40 mg/ml / Liquid Trimethoprim + sulfamethoxazole, 8/40 mg/ml / Liquid Trimethoprim + sulfamethoxazole, 8/40 mg/ml / Liquid Trimethoprim + sulfamethoxazole, 8/40 mg/ml / Liquid Trimethoprim + sulfamethoxazole, 8/40 mg/ml / Liquid Trimethoprim + sulfamethoxazole, 80/400 mg / Tablet Trimethoprim + sulfamethoxazole, 80/400 mg / Tablet Trimethoprim + sulfamethoxazole, 80/400 mg / Tablet Trimethoprim + sulfamethoxazole, 80/400 mg / Tablet Trimethoprim + sulfamethoxazole, 80/400 mg / Tablet Alti-Valproic (AltiMed Pharmaceutical Company) Nd Vitamine E (Santé NaturelleTM Adrien Gagnon) * The caloric content indicated is for one ml, one tablet or one capsule unless otherwise indicated. CH§ = carbohydrate. Nd = No data. When no data is available for caloric content provided by carbohydrates, we suggest the use of total caloric content.
Volume 28, No. 4 – November 2001 THE CANADIAN JOURNALOF NEUROLOGICALSCIENCES Table 2: Worst case scenario study data

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