Topamax Dosage

Generic name: topiramate
Brand names: Topamax, Topamax Sprinkle
Drug class: Carbonic anhydrase inhibitor anticonvulsants

Medically reviewed by  A Ras MD

 Recommended Adult Dosing

Dosage forms:  SPRINKLE CAP: 15 mg, 25 mg; TAB: 25 mg, 50 mg, 100 mg, 200 mg

Partial seizures

[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: taper dose gradually to D/C

[adjunct tx]

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, may incr. ADR risk; taper dose gradually to D/C

Seizures, primary generalized tonic clonic

[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: taper dose gradually to D/C

[adjunct tx]

Dose: 200 mg PO bid; Start: 25 mg PO qd-bid x1wk, incr. by 25-50 mg/day qwk; Info: taper dose gradually to D/C

Seizures, Lennox-Gastaut syndrome

[adjunct tx]

Dose: 100-200 mg PO bid; Start: 25 mg PO qd-bid x1wk, incr. by 25-50 mg/day qwk; Info: taper dose gradually to D/C

Migraine headache prophylaxis

[50 mg PO bid]

Start: 25 mg PO qhs x1wk, incr. by 25 mg/day qwk; Max: 200 mg/day; Info: taper dose gradually to D/C

Sleep-related eating disorder

[25-100 mg PO qhs]

Start: 25 mg PO qhs x1wk, then may incr. by 25 mg/day qwk; Info: taper dose gradually to D/C

Nightmares, post-traumatic stress disorder-assoc.

[75 mg PO qhs]

Start: 25 mg PO qhs x1wk, then incr. by 25 mg/day qwk; Info: taper dose gradually to D/C

*Alcohol dependence

[100-150 mg PO bid]

Start: 25 mg PO qd x1wk, then incr. by 25 mg/day qwk; Info: taper dose gradually to D/C

Renal dosing

[adjust dose amount]

CrCl <70: decr. usual dose by 50%

HD: decr. usual dose, amount not defined, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined

Hepatic dosing

[not defined]

hepatic impairment: caution advised

SRC: NLM .