One tablet, once daily given in the morning. The dose may be increased to two tablets, the whole dose to be given together (dose range 25 to 120 mg).
For Isotard 60 mg XL only, the dose can be titrated to minimise the possibility of headache by initiating treatment with half a tablet (30 mg) for the first two to four days.
The tablets should not be chewed or crushed and should be swallowed with half a glass of fluid.
The safety and efficacy of Isotard XL ISMN prolonged release tablets has not been established.
No need for routine dosage adjustment in the elderly has been found, but special care may be needed in those with increased susceptibility to hypotension or marked hepatic or renal insufficiency.
The lowest effective dose should be used.
Attenuation of effect (tolerance) has occurred in some patients being treated with prolonged release preparations. In such patients intermittent therapy may be more appropriate (see Section 4.4).
Therapy should not be discontinued suddenly. Both dosage and frequency should be tapered gradually (see Section 4.4).
The core of the tablet is insoluble in the digestive juices but disintegrates into small particles when all the active substance has been released. Very occasionally the matrix may pass through the gastrointestinal tract without disintegrating and be found inside the stool, but all active substance has been released.