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Dosing starts low to avoid side effects. Adults begin with 5 mg three times daily. Increases occur by 5 mg weekly. Maximum reaches 80 mg per day in divided doses. Elderly patients use 5 mg twice daily initially. Children over 12 weigh-based: 0.3 mg/kg/day divided. Renal impairment halves doses. Titration monitors response closely. Food aids absorption slightly. Missed doses resume schedule without doubling. Intrathecal starts at 50 mcg daily via pump. Oral switch requires careful conversion. Duration limits to needs, often months. Physicians adjust per severity. Compliance tools like reminders aid adherence. Examples: MS patients stabilize at 40 mg daily for optimal control.
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