Topiramate
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
- Pregnancy Rating: D
- Lactation risk: Excreted in breastmilk
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