Precautions
feeling sick - stick to simple meals and do not eat rich or spicy food. It might help to take your topiramate after a meal or snack. feeling sleepy, dizzy or tired - do not drive or use tools or machinery. Try to avoid drinking alcohol, as this will make you feel more tired.
What not to take with topiramate?
Topiramate may cause changes in body temperature or changes in blood ammonia. According to the FDA-approved prescribing information, a side effect of topiramate is decreased sweating with increased body temperature, or hyperthermia 1. This rare side effect typically occurrs about 4 to 5 months after starting treatment.
What are the side effects of topiramate?
Topiramate Side Effects
- In Summary. ...
- For the Consumer. ...
- For Healthcare Professionals. ...
- Frequently asked questions. ...
What are the long term side effects of Topamax?
Your doctor can monitor you while you taper off the drug, and treat any symptoms such as:
- seizures
- side effects like allergic reaction, fever, nausea, tremors, or double vision
- withdrawal symptoms such as sweating, dizziness, fatigue, headaches, and others
- worsening of your condition or symptoms
How hard is it to come off topiramate?
What can topiramate treat?
Topiramate is used alone or with other medications to treat certain types of seizures including primary generalized tonic-clonic seizures (formerly known as a grand mal seizure; seizure that involves the entire body) and partial onset seizures (seizures that involve only one part of the brain).
Why would a doctor prescribe Topamax?
Topamax (topiramate) is a drug approved to treat seizures in adults and children and to reduce the frequency of migraine headaches in people 12 years of age and older. For the treatment of seizures, Topamax may be used alone or in combination with other medications.
What are the main side effects of topiramate?
AdvertisementBlurred vision.burning, prickling, or tingling sensations.clumsiness or unsteadiness.continuous, uncontrolled back-and-forth or rolling eye movements.drowsiness.eye redness or pain.generalized slowing of mental and physical activity.increased eye pressure.More items...•
Is topiramate used for weight loss?
Key Points. Yes, topiramate (Topamax) has been shown to cause weight loss when used for both seizure control and migraine prevention. Topiramate (used by itself) is not specifically approved by the FDA for weight loss, but some doctors may prescribe it if you have seizures or migraine and need to lose weight, too.
Does topiramate help anxiety?
The study found that the participants taking Topamax in addition to their prescribed depression medication significantly improved depressed mood, suicidality, insomnia, agitation, and anxiety symptoms compared to those taking a placebo.
Is topiramate an antidepressant?
Topiramate is most useful for people who have bipolar mood disorders that other mood stabilizers have been unable to control. It can relieve symptoms and make taking antidepressants possible for people who ere unable to take them before without experiencing mania or a mixed state.
Does topiramate help you sleep?
Conclusions: Topiramate may be of benefit for patients with NES or SRED in reducing nocturnal eating, improving nocturnal sleep, and producing weight loss.
Is topiramate a narcotic?
Topamax (generic name: topiramate) is not classified as a controlled substance under the U.S. Controlled Substances Act (CSA). Topamax is an anticonvulsant (seizure) medication, but is also prescribed for other conditions such as prevention of migraine.
Can topiramate cause permanent damage?
In most cases, side effects from Topamax are temporary. Most side effects tend to go away soon after you start or stop taking the drug. But severe side effects that could lead to long-term problems and permanent damage from Topamax are possible. For example, Topamax may cause eye side effects,* such as glaucoma.
How fast does topiramate work for weight loss?
It can take some time to see weight loss results from taking Topamax. Some people may not notice a difference until they've taken the drug for at least four months, while other people may start to lose weight in their first month of taking it. Weight loss results from topiramate are proven to increase over time.
How much weight can you lose with topiramate?
All patients lost a substantial amount of weight on topiramate. The average weight loss was 22 lb (10 kg; range, 8–56 lb [4–25 kg]). No patient discontinued topiramate because of side effects.
What is the strongest weight loss prescription pill?
Phentermine-Topiramate extended release (Qsymia) is the most effective weight loss drug available to date. It combines an adrenergic agonist with a neurostabilizer. Daily doses with four strengths start at 3.75/23mg to 15mg/92mg.
Does topiramate cause weight loss?
Yes, topiramate (Topamax) has been shown to cause weight loss when used for both seizure control and migraine prevention. Topiramate by itself is n...
Does topiramate cause hair loss?
Yes, topiramate has been shown to cause hair loss in studies, but it is not a common side effect. Hair loss (also called alopecia) has been reporte...
How long do you stay on Topamax for migraines?
You can usually stay on Topamax (topiramate) to help prevent your migraine headaches as long as the treatment is needed and remains safe for you. Y...
How long does it take for Topamax to start working?
It may take 8 to 12 weeks for you to see the full effect of Topamax on your migraine headaches. In clinical studies, some people had fewer headache...
How long does Topamax stay in your system?
Topamax stays in your system for approximately 4 to 5 days after the last dose, but this may vary depending on personal factors, such as your age,...
How does Trokendi XR help with weight loss?
Trokendi (topiramate) XR can lead to weight loss when used for prevention of migraine headaches or seizures, but it is not approved as a weight los...
What is topiramate used for?
Topiramate is a seizure medicine, also called an anticonvulsant. Topiramate is used to treat certain types of seizures in adults and children who are at least 2 years old. Trokendi XR is for use in adults and children who are at least 6 years old. Some brands of topiramate are also used to prevent migraine headaches in adults ...
What is Trokendi XR used for?
Trokendi XR is for use in adults and children who are at least 6 years old. Some brands of topiramate are also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. These medicines will only prevent migraine headaches or reduce the number of attacks, but will not treat a headache that has already begun.
What is metabolic acidosis?
metabolic acidosis (high levels of acid in your blood); kidney disease, kidney stones, or dialysis; lung disease, breathing problems; mood problems, depression, or suicidal thoughts or actions; liver disease; a growth disorder; or. soft or brittle bones ( osteoporosis, osteomalacia).
What are the symptoms of a cold?
problems with speech or memory; abnormal vision; numbness or tingling in your arms and legs, decreased sensation (especially in the skin); changes in your sense of taste; feeling nervous; nausea, diarrhea, stomach pain, loss of appetite; fever, weight loss; or. cold symptoms such as stuffy nose, sneezing, sore throat.
How do you know if you have kidney stones?
signs of a kidney stone--severe pain in your side or lower back, painful or difficult urination; signs of too much acid in your blood--irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or.
Can topiramate cause vision problems?
Topiramate may cause vision problems that can be permanent if not treated quickly. Call your doctor right away if you have a sudden decrease in vision. topiramate may increase the risk of a birth defect called cleft lip and palate in a newborn. There may be other medications that are safer to use during pregnancy.
Can topiramate be used for birth control?
Topiramate can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy. It may not be safe to breastfeed a baby while you are using this medicine. Ask your doctor about any risks.
What is topiramate used for?
Topiramate is used for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut Syndrome. It is also frequently prescribed "off-label" for other uses such as alcohol dependence, but this use is not approved by the FDA. Topiramate is classified as a carbonic anhydrase inhibitor ...
How much Trokendi XR is available?
Trokendi XR is available as an extended-release capsule (25 mg, 50 mg, 100 mg, and 200 mg) and is used to help control certain types of seizures in adults and children who are at least 6 years old. It is also approved to prevent migraine headaches in adults and adolescents who are at least 12 years old. It can be taken once a day.
How does gABA work?
Experts think it works by quieting excessive nerve activity in the brain and central nervous system, increasing the actions of GABA, and blocking the effects of other chemical messengers (neurotransmitters).
Is Topamax a generic?
Topamax is available as a tablet (25 mg, 50 mg, 100 mg, and 200 mg) or capsule (15 mg, 25 mg) and is approved to control seizures and for migraine prevention. Generic options are approved. Topamax Sprinkle capsules have been discontinued.
Can you take Qudexy XR whole?
Qudexy XR comes as an extended-release capsule (25 mg, 50 mg, 100 mg, 150 mg and 200 mg) and is used alone or with other medicines to control certain types of seizures in patients 2 years and older and to help prevent migraine headaches in people 12 years and older. Qudexy XR capsules may be swallowed whole or opened and sprinkled on a spoonful ...
Is Qudexy XR generic?
Qudexy XR is available as a generic option. This is not all the information you need to know about topiramate for safe and effective use. Review the full topiramate information here, and discuss this information and any questions you have with your doctor or other health care provider. References. Topiramate.
What are the side effects of Topamax?
Topamax has a number of side effects that tend to be transient and resolve on their own as the body adapts to the treatment. Most are mild to moderate in severity. Common side effects include: 2 . Diarrhea. Dizziness. Double vision. Loss of appetite. Mood changes.
Can Topamax cause cleft palate?
Pregnancy: Topamax is classified as a category D drug due to evidence that it may cause a cleft palate in some children.
How do you know if you have a kidney problem?
Symptoms usually appear within a month of starting treatment and may be recognized by the sudden blurring of vision, eye pain, redness, and abnormally dilated pupils. Kidney damage: This most often affects people over 65 who have an underlying kidney disorder.
What is the best medicine for epilepsy?
Epilepsy drugs: Such as Diamox (acetazolamide) and Zonegran (zonisamide) Glaucoma medications: Such as Azopt (brinzolamide), Neptazane (methazolamide), and Trusopt (dorzolamide) Estrogen-based contraceptives may also be compromised if taking Topamax, increasing the risk of pregnancy and breakthrough bleeding.
How many mg of a sulfate capsule?
The capsule is available in 15-mg or 25-mg dose. The dosage can vary by the condition and the age of the user. 1 . When starting treatment, the dosage is typically tapered up to reduce the risk of potential side effects. It should also be tapered down if the decision is made to stop treatment.
Can you break a Topamax capsule?
Stopping abruptly can cause a rebound of disease symptoms (such as seizures in people with epilepsy or abnormal moods in people with bipolar disorder). When prescribed for smaller children, the Topamax capsule can be broken open and its contents sprinkled over food.
Is Topamax a drug?
Side Effects. Considerations. Drug Interactions. Topamax (topiramate) is an anticonvulsant medication used in the treatment of epilepsy and migraine headaches. 1 Topamax is also commonly used off-label to treat a wide range of mood disorders, eating disorders, and to aid in substance abuse therapy. While Topamax's mechanism of action is unclear, ...
What is topiramate used for?
Topiramate is a medication that works in the brain and is sometimes used in patients with bipolar disorder (also known as manic depression). It is approved for the treatment of seizures (epilepsy) in adults and children in combination with other anticonvulsants and for preventing migraine headaches in adults. ...
How much topiramate should I take?
Topiramate is usually taken one or two times a day with or without food. Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks. The dose usually ranges from 25 mg to 400 mg. Only your healthcare provider can determine the correct dose for you.
What are the side effects of a syringe?
Thinking problems: slow thoughts, trouble finding the right word, confusion, trouble concentrating. Feel clumsy, unsteady, dizzy, tired, weak, or nervous. Loss of appetite, change in the way food tastes, weight loss, stomach pain. Numbness or tingling sensation in limbs and extremities.
How do you know if you are depressed?
Symptoms of depression include: Depressed mood — feeling sad, empty, or tearful. Feeling worthless, guilty, hopeless, or helpless. Loss of interest or pleasure in normal activities. Sleep and eat more or less than usual (for most people it is less)
Does topiramate increase ammonia?
Combining valproate (Depakote®) with topiramate may increase ammonia levels in your blood. If this happens, you may get confused, disoriented, or have difficulty thinking.
Does topiramate cause sweating?
Topiramate may cause decreased sweating and increased body temperature. People, especially children, should be watched for signs of this — especially in hot climates. Some people may need to be hospitalized for this condition. Topiramate can increase the level of acid in your blood (metabolic acidosis).
Does topiramate cause birth defects?
It is important to discuss the risks and benefits of treatment with your doctor and caregivers. Topiramate has been associated with an increased risk of oral cleft birth defects. There may be precautions to decrease the risk of this effect.
What is topiramate used for?
Medically reviewed by Carmen Fookes, BPharm. Last updated on Dec 3, 2020. 1. How it works. Topiramate reduces the frequency and duration of seizures and is used in the treatment of certain types of epilepsy. It also prevents the development of migraine headaches.
What medications interact with topiramate?
Speak to your doctor about how drug interactions should be managed. Common medications that may interact with topiramate include: acetazolamide. amitriptyline.
What are the side effects of topiramate?
Downsides. If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Drowsiness which may affect your ability to drive or operate machinery. Avoid alcohol.
How long does it take to see the effects of topiramate?
Some effects apparent within a few days of taking topiramate; however, it may take up to eight weeks before the full effects seen.
How long does it take for glaucoma to cause eye pain?
Sudden eye pain and decreased vision associated with or without glaucoma have been reported; symptoms may occur in both children and adults and typically start within 1 month of starting therapy . Seek urgent medical attention; drug discontinuation may be necessary to avoid permanent vision loss.
Is topiramate bioequivalent to sprinkle?
The sprinkle formulation of topiramate and the immediate-release tablet formulation of topiramate are bioequivalent (this means they are absorbed to the same extent and are interchangeable). 7. Interactions.
Does topiramate cause fever?
Keep up your fluid intake and avoid dehydration as topiramate can increase the risk of kidney stones developing. Topiramate may also make you sweat less or give you a fever. Contact your doctor if your fever does not go away, you develop abdominal pain with or without vomiting, or you are unable to sweat.
What to do if side effects persist?
If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
How often should I take topiramate?
For some conditions, you may start treatment with topiramate once daily at bedtime and slowly increase your dose to twice a day. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication. Take this medication regularly to get the most benefit from it.
What medications cause drowsiness?
Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana ( cannabis ), antihistamines (such as cetirizine, diphenhydramine ), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).
What to do if you are allergic to topiramate?
This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
What are the effects of a syringe?
Tiredness, drowsiness, dizziness, loss of coordination, tingling of the hands/feet, loss of appetite, bad taste in your mouth, diarrhea, and weight loss may occur. Mental problems such as confusion, slowed thinking, trouble concentrating or paying attention, nervousness, memory problems, or speech/ language problems may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
What to do if you have a fever that doesn't go away?
Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
How often should I take a sulfate supplement?
Take this medication by mouth with or without food as directed by your doctor, usually twice daily. Swallow the tablets whole since breaking them may leave a bitter taste. To prevent kidney stones from forming, drink plenty of liquids while taking this medication unless your doctor instructs you otherwise.
What is topiramate used for?
Topiramate is used to treat certain types of seizures in adults and children ages 2 years and older. These types of seizures include: Partial onset seizures. Also called a focal onset seizure, this is a seizure that begins in one half of your brain.
How long does it take to see improvement in topiramate?
So, it may take a few weeks or a month for you to notice an improvement in your condition. Questions for your doctor. You may have questions about topiramate oral tablets and your treatment plan. It’s important to discuss all your concerns with your doctor.
What are the interactions of topiramate?
Interactions. Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions. Before taking topiramate oral tablets, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types.
What are the side effects of topiramate?
Serious side effects of topiramate oral tablet that have been reported include: increased acid level in your blood. increased ammonia level in your blood. decreased sweating that can lead to fever. problems with thinking, memory, attention, and reaction. suicidal thoughts or actions.
Can topiramate be taken with other drugs?
Taking topiramate oral tablet with other drugs. To treat certain types of seizures, topiramate oral tablet is used in combination with other medications that treat seizures. These drugs belong to a group of medications called antiepileptic drugs (AEDs). Some examples of other commonly prescribed AEDs include:
Is topiramate a generic drug?
Topiramate is a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that topiramate oral tablets are based on is called Topamax. Generic drugs are thought to be as safe and effective as the brand-name drug they’re based on.
Can topiramate help with seizures?
If you have migraine headaches or certain types of seizures, your doctor may prescribe topiramate for you. It’s a prescription medication that’s used in adults and some children to: treat certain types of seizures. help prevent migraine headaches.
What is the best medicine for seizures?
Topiramate is used to treat seizures in adults and children who are at least 2 years old. Topamax is also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. This medicine will only prevent migraine headaches or reduce the number of attacks.
When to take Topamax?
When taken twice a day, the medicine is usually taken in the morning and evening.
What to ask your doctor before taking a sleeping pill?
Ask your doctor before taking a sleeping pill, opioid pain medication, muscle relaxer, or medicine for anxiety or depression. Tell your doctor about all your current medicines and any you start or stop using, especially: zonisamide; birth control pills; divalproex, valproic acid; or.
Can you take topiramate with metformin?
You should not use extended-release topiramate if you have metabolic acidosis (high levels of acid in your blood) and are also taking metformin for diabetes. To make sure Topamax is safe for you, tell your doctor if you have ever had: glaucoma or other eye problems; diabetes, or metabolic acidosis;
What are the conditions that cause a person to be sick?
kidney disease, kidney stones, or dialysis; lung disease, breathing problems; mood problems, depression, or suicidal thoughts or actions; an eating disorder; liver disease; soft or brittle bones ( osteoporosis, osteomalacia ); a growth disorder; or. if you are sick with diarrhea.
Can Topamax cause vision problems?
Topamax may cause vision problems that can be permanent if not treated quickly. Call your doctor right away if you have a sudden decrease in vision. Topamax can decrease sweating and may cause life-threatening hyperthermia (especially in children). Avoid becoming overheated or dehydrated.
Is Topamax a controlled substance?
Topamax is not classified as a controlled substance under the U .S. Controlled Substances Act (CSA). Topamax is an anticonvulsant (seizure) medication, but is also prescribed for other conditions such as prevention of migraine. It may causes side effects like confusion, drowsiness, dizziness, or blurred vision.
Usual Adult Dose for Epilepsy
MONOTHERAPY: Immediate-Release: 400 mg orally daily in 2 divided doses -The dose should be achieved by titration according to the following schedule: Week 1: 25 mg orally in the AM and 25 mg orally in the PM Week 2: 50 mg orally in the AM and 50 mg orally in the PM Week 3: 75 mg orally in the AM and 75 mg orally in the PM Week 4: 100 mg orally in the AM and 100 mg orally in the PM Week 5: 150 mg orally in the AM and 150 mg orally in the PM Week 6: 200 mg orally in the AM and 200 mg orally in the PM Extended-Release: 400 mg orally once a day -The dose should be achieved by titration according to the following schedule: Week 1: 50 mg orally once a day Week 2: 100 mg orally once a day Week 3: 150 mg orally once a day Week 4: 200 mg orally once a day Week 5: 300 mg orally once a day Week 6: 400 mg orally once a day ADJUNCTIVE THERAPY: Immediate-Release: -Partial onset seizures: 200 to 400 mg orally daily in 2 divided doses -Primary generalized tonic-clonic seizures: 400 mg orally daily in 2 divided doses The dose should be achieved by titration: Initiate with 25 to 50 mg orally once a day; increase in increments of 25 to 50 mg orally daily every week to an effective dose. Extended-Release: -Partial onset seizures: 200 to 400 mg orally once a day -Primary generalized tonic-clonic seizures: 400 mg orally once a day The dose should be achieved by titration: Initiate therapy at 25 to 50 mg orally once a day followed by titration in increments of 25 to 50 mg every week to an effective dose. Comments: -Dose titration rate should be guided by clinical outcome, if needed, longer intervals between dose increases may be used. -Doses above 400 mg daily have not been shown to improve responses in dose-response studies in adults with partial onset seizures. -Daily topiramate doses above 1600 mg have not been studied. -Co-administration with phenytoin and/or carbamazepine may require dose adjustments. Uses: -Initial monotherapy or adjunctive therapy for patients with partial onset or primary generalized tonic-clonic seizures..
Usual Adult Dose for Migraine Prophylaxis
IMMEDIATE RELEASE: 100 mg orally daily in 2 divided doses The dose should be achieved by titration: If required, longer intervals between dose adjustments can be used Week 1: No dose in the AM and 25 mg orally in the PM Week 2: 25 mg orally in the AM and 25 mg orally in the PM Week 3: 25 mg orally in the AM and 50 mg orally in the PM Week 4: 50 mg orally in the AM and 50 mg orally in the PM EXTENDED-RELEASE: 100 mg orally once a day The dose should be achieved by titration: If required, longer intervals between dose adjustments can be used Week 1: 25 mg orally once a day Week 2: 50 mg orally once a day Week 3: 75 mg orally once a day Week 4: 100 mg orally once a day Comments: -Dose titration rate should be guided by clinical outcome, if needed, longer intervals between dose adjustments may be used. Use: For the prophylaxis of migraine headache.
Usual Adult Dose for Lennox-Gastaut Syndrome
Immediate-Release: 200 to 400 mg orally daily in 2 divided doses -Initiate with 25 to 50 mg orally once a day; increase in increments of 25 to 50 mg per week to an effective dose. Extended-Release: 200 to 400 mg orally once a day -Initiate therapy at 25 to 50 mg orally once a day followed by titration in increments of 25 to 50 mg per week to an effective dose. Comments: -Doses above 400 mg daily have not been shown to improve responses in dose-response studies in adults with partial onset seizures. -Daily topiramate doses above 1600 mg have not been studied. -Co-administration with phenytoin and/or carbamazepine may require dose adjustments. Use: Adjunctive therapy for patients with seizures associated with Lennox-Gastaut syndrome (LGS)..
Usual Pediatric Dose for Epilepsy
MONOTHERAPY: 2 to less than 10 years old: IMMEDIATE-RELEASE: -Week 1: 25 mg orally once a day in the evening; If tolerated, increase to 25 mg orally twice a day for Week 2; Thereafter, increase by 25 to 50 mg/day each week as tolerated -Titration to the minimum maintenance dose should be attempted over 5 to 7 weeks; based upon tolerability and clinical response, titration to a higher dose (up to the maximum maintenance dose) can be attempted weekly in increments of 25 to 50 mg/day Maintenance Dose (administered in 2 equally divided doses): -Weight: Up to 11 kg: Minimum: 150 mg/day; Maximum: 250 mg/day -Weight: 12 to 22 kg: Minimum: 200 mg/day; Maximum: 300 mg/day -Weight: 23 to 31 kg: Minimum: 200 mg/day; Maximum: 350 mg/day -Weight: 32 to 38 kg: Minimum: 250 mg/day; Maximum: 350 mg/day -Weight: Greater than 38 kg: Minimum: 250 mg/day; Maximum: 400 mg/day EXTENDED-RELEASE: -Week 1: 25 mg orally once a day in the evening; If tolerated, increase to 50 mg orally once a day for Week 2; Thereafter, increase by 25 to 50 mg/day each week as tolerated -Titration to the minimum maintenance dose should be attempted over 5 to 7 weeks; based upon tolerability and clinical response, titration to a higher dose (up to the maximum maintenance dose) can be attempted weekly in increments of 25 to 50 mg/day.
Usual Pediatric Dose for Lennox-Gastaut Syndrome
MONOTHERAPY: 2 to less than 10 years old: IMMEDIATE-RELEASE: -Week 1: 25 mg orally once a day in the evening; If tolerated, increase to 25 mg orally twice a day for Week 2; Thereafter, increase by 25 to 50 mg/day each week as tolerated -Titration to the minimum maintenance dose should be attempted over 5 to 7 weeks; based upon tolerability and clinical response, titration to a higher dose (up to the maximum maintenance dose) can be attempted weekly in increments of 25 to 50 mg/day Maintenance Dose (administered in 2 equally divided doses): -Weight: Up to 11 kg: Minimum: 150 mg/day; Maximum: 250 mg/day -Weight: 12 to 22 kg: Minimum: 200 mg/day; Maximum: 300 mg/day -Weight: 23 to 31 kg: Minimum: 200 mg/day; Maximum: 350 mg/day -Weight: 32 to 38 kg: Minimum: 250 mg/day; Maximum: 350 mg/day -Weight: Greater than 38 kg: Minimum: 250 mg/day; Maximum: 400 mg/day EXTENDED-RELEASE: -Week 1: 25 mg orally once a day in the evening; If tolerated, increase to 50 mg orally once a day for Week 2; Thereafter, increase by 25 to 50 mg/day each week as tolerated -Titration to the minimum maintenance dose should be attempted over 5 to 7 weeks; based upon tolerability and clinical response, titration to a higher dose (up to the maximum maintenance dose) can be attempted weekly in increments of 25 to 50 mg/day.
Usual Pediatric Dose for Migraine Prophylaxis
12 years or older: IMMEDIATE RELEASE: 100 mg orally daily in 2 divided doses The dose should be achieved by titration: if needed, longer intervals between dose increases may be used -Week 1: No dose in the AM and 25 mg orally in the PM -Week 2: 25 mg orally in the AM and 25 mg orally in the PM -Week 3: 25 mg orally in the AM and 50 mg orally in the PM -Week 4: 50 mg orally in the AM and 50 mg orally in the PM EXTENDED-RELEASE: 100 mg orally once a day The dose should be achieved by titration: if needed, longer intervals between dose increases may be used -Week 1: 25 mg orally once a day -Week 2: 50 mg orally once a day -Week 3: 75 mg orally once a day -Week 4: 100 mg orally once a day Comments: -Dose titration rate should be guided by clinical outcome, if needed, longer intervals between dose increases may be used. Use: For pediatric patients 12 years or older for the prevention of migraine headache..
Dose Adjustments
Topiramate plasma level monitoring is not required to optimize therapy. Dosage adjustments may be required following addition or withdrawal of phenytoin and/or carbamazepine. Drug Discontinuation: -Antiepileptic drugs including topiramate should not be abruptly discontinued. -Antiepileptic drugs should be gradually withdrawn in patients both with or without a history of seizures or epilepsy so as to minimize the potential for seizures or increased seizure frequency. -In situations where rapid withdrawal is medically required, appropriate monitoring will be necessary..
