Topiramate

Administration

• Type: anti epileptic
• Dosage Forms: 25,50,100,200 tabs; 15,25 caps
• Routes of Administration: PO
• Common Trade Names: Topamax

Adult Dosing

Partial Seizures

• monotherapy
  • Dose: 200mg PO bid; Start: 25mg PO bid x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective
• adjunct therapy
  • Dose: 100-200mg PO bid; Start: 25mg PO qd-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective

seizures, primary generalized tonic clonic

• monotherapy
  • Dose: 200mg PO bid; Start: 25mg PO bid x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective
• adjunct therapy
  • Dose: 200mg PO bid; Start: 25mg PO qd-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective

Seizures, Lennox-Gastaut

• adjunct therapy
  • Dose: 100-200mg PO bid; Start: 25mg PO qd-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective

Migraine headache, prophylaxis

• 50mg PO bid
  • Start: 25mg PO qhs x1wk, increase by 25mg/day qwk; Max: 200mg/day

Special Populations

• Pregnancy Rating:
• Lactation risk:

Renal Dosing

• Adult: CrCl 10-70: decrease dose 50%; CrCl <10: decrease dose 75%; HD: give supplement
• Pediatric:

Hepatic Dosing

• Adult: not defined; caution advised
• Pediatric:

Contraindications

• Allergy to class/drug

Pharmacology

• Half-life:
• Metabolism:
• Excretion:

References

Authors

Jung-Eun Lim, Claire, Neil Young, Daniel Ostermayer