Topiramate: Difference between revisions

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==Administration==
==Administration==
*Type: anti epileptic
*Type: [[antiepileptics]]
*Dosage Forms: 25,50,100,200 tabs; 15,25 caps
*Dosage Forms: 25mg, 50mg, 100mg, 200mg tabs; 15mg, 25mg caps
*Routes of Administration: PO
*Routes of Administration: PO
*Common Trade Names: Topamax
*Common Trade Names: Topamax
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===Partial Seizures===
===Partial Seizures===
*monotherapy
*monotherapy
**Dose: 200 mg PO bid; Start: 25 mg PO bid x1wk, incr. by 50 mg/day qwk until 100 mg PO bid, then incr. by 100 mg/day qwk; Info: doses >400 mg/day rarely more effective
**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
*adjunct therapy
**Dose: 100-200 mg PO bid; Start: 25 mg PO qd-bid x1wk, incr. by 25-50 mg/day qwk; Info: doses >400 mg/day rarely more effective
**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===
===seizures, primary generalized tonic clonic===
*monotherapy
*monotherapy
**Dose: 200 mg PO bid; Start: 25 mg PO bid x1wk, incr. by 50 mg/day qwk until 100 mg PO bid, then incr. by 100 mg/day qwk; Info: doses >400 mg/day rarely more effective
**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
*adjunct therapy
**Dose: 200 mg PO bid; Start: 25 mg PO qd-bid x1wk, incr. by 25-50 mg/day qwk; Info: doses >400 mg/day rarely more effective
**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===
===Seizures, Lennox-Gastaut===
*adjunct therapy
*adjunct therapy
**Dose: 100-200 mg PO bid; Start: 25 mg PO qd-bid x1wk, incr. by 25-50 mg/day qwk; Info: doses >400 mg/day rarely more effective
**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===
===Migraine headache, prophylaxis===
*50 mg PO bid
*50mg PO bid
**Start: 25 mg PO qhs x1wk, incr. by 25 mg/day qwk; Max: 200 mg/day
**Start: 25mg PO qhs x1wk, increase by 25mg/day qwk; Max: 200mg/day


==Pediatric Dosing==
==Pediatric Dosing==


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D
*[[Lactation risk categories|Lactation risk]]:
*[[Lactation risk categories|Lactation risk]]: Excreted in breastmilk
===Renal Dosing===
===Renal Dosing===
*Adult: CrCl 10-70: decr. dose 50%; CrCl <10: decr. dose 75%; HD: give supplement
*Adult: CrCl 10-70: decrease dose 50%; CrCl <10: decrease dose 75%; HD: give supplement
*Pediatric:
*Pediatric:
===Hepatic Dosing===
===Hepatic Dosing===
*Adult: not defined; caution advised
*Adult: not defined; caution advised
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==Mechanism of Action==
==Mechanism of Action==
*Unclear, however has activity on voltage-gated sodium channels, calcium channels, GABA-A receptors, and carbonic anhydrase enzymes


==Comments==
==Comments==


==See Also==
==See Also==
*[[Seizure]]
*[[Anticonvulsants]]
*[[Anticonvulsant levels and reloading]]


==References==
==References==
<references/>
<references/>
[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:Neurology]]

Latest revision as of 15:51, 8 March 2021

Administration

  • Type: antiepileptics
  • Dosage Forms: 25mg, 50mg, 100mg, 200mg tabs; 15mg, 25mg 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

Pediatric Dosing

Special Populations

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

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:

Mechanism of Action

  • Unclear, however has activity on voltage-gated sodium channels, calcium channels, GABA-A receptors, and carbonic anhydrase enzymes

Comments

See Also

References

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