Topiramate(toe pie’ rah mate)
Gen-Topiramate (CAN), PMS-Topiramate (CAN), ratio-Topiramate (CAN), TopamaxDNC, Topamax Sprinkle, Topiragen, Trokendi XRDNC
PREGNANCY CATEGORY D
Drug Classes
Antiepileptic
Antimigraine
Therapeutic Actions
Mechanism of action not understood; antiepileptic effects may be due to the actions of blocking sodium channels in neurons with sustained depolarization; increasing GABA activity at receptors, thus potentiating the effects of this inhibitory neurotransmitter; and blocking excitatory neurotransmitters at neuron receptor sites.
Indications
Monotherapy for the treatment of patients 2 yr and older with partial-onset or primary generalized tonic-clonic seizures; 10 yr and older for ER forms
Adjunctive therapy for partial-onset seizure treatment in adults and children 2–16 yr; 6 yr and older for ER forms
Adjunctive therapy for seizures associated with Lennox-Gastaut syndrome in adults and children older than 2 yr
Adjunctive therapy for primary generalized tonic-clonic seizures in adults and children 2–16 yr
Prophylaxis of migraine headaches in adults
Unlabeled uses: Cluster headaches, infantile spasms, alcohol dependence, bulimia nervosa, weight loss, smoking cessation, restless legs syndrome, neuropathic pain, essential tumor, bipolar disorder
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug; pregnancy.
Use cautiously with lactation, renal or hepatic impairment, renal stones, glaucoma.
Available Forms
TabletsDNC—25, 50, 100, 200 mg; sprinkle capsules—15, 25 mg
Dosages
Adults 17 yr and older
Migraine prophylaxis: Initially, 25 mg PO in the evening for 1 wk; week 2—25 mg PO bid, morning and evening; week 3—25 mg PO in the morning and 50 mg PO in the evening; week 4—50 mg PO morning and evening.
Seizure disorder: 200–400 mg PO daily in two divided doses. Therapy should be initiated at a dose of 25–50 mg/day titrated up in increments of 25–50 mg/wk. ER forms: Initially, 25–50 mg/day PO; increase weekly in 25- to 50-mg increments to recommended dose of 200–400 mg/day PO.
Patients 10 yr and older
Monotherapy for epilepsy: 25 mg PO bid, titrating to maintenance dose of 200 mg PO bid over 6 wk. Wk 1—25 mg PO bid; wk 2—50 mg PO bid; wk 3—75 mg PO bid; wk 4—100 mg PO bid; wk 5—150 mg PO bid; wk 6—200 mg PO bid. ER forms: Initially, 50 mg/day PO; titrate in increments of 50 mg/wk for first 4 wk, then 100 mg/wk to a recommended dose of 400 mg/day PO.
Pediatric patents 6 yr and older
Seizure disorder: ER forms: 25 mg PO at bedtime; range, 1–3 mg/kg for first wk. Increase in 1- to 2-wk intervals by 1- to 3-mg/kg increments to recommended dose of 5–9 mg/kg/day.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
