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topiramate

generic

Drug Monograph

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Adult Dosing
Peds Dosing
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Dosing Calculator

Adult Dosing .

Dosage forms: ER CAP: 25 mg, 50 mg, 100 mg, 200 mg; ER SPRINKLE CAP: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg; SPRINKLE CAP: 15 mg, 25 mg; TAB: 25 mg, 50 mg, 100 mg, 200 mg

partial seizures

[monotherapy, immediate-release form]: 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

[monotherapy, extended-release form]: Dose: 400 mg ER PO qd; Start: 50 mg ER PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg ER PO qd, then incr. by 100 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

[adjunct tx, immediate-release form]: 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

[adjunct tx, extended-release form]: Dose: 200-400 mg ER PO qd; Start: 25-50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: doses >400 mg/day rarely more effective, may incr. ADR risk; may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

seizures, primary generalized tonic clonic

[monotherapy, immediate-release form]: 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

[monotherapy, extended-release form]: Dose: 400 mg ER PO qd; Start: 50 mg ER PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg ER PO qd, then incr. by 100 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

[adjunct tx, immediate-release form]: 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

[adjunct tx, extended-release form]: Dose: 400 mg ER PO qd; Start: 25-50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

seizures, Lennox-Gastaut syndrome

[adjunct tx, immediate-release form]: 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

[adjunct tx, extended-release form]: Dose: 200-400 mg ER PO qd; Start: 25-50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

migraine prophylaxis

[immediate-release form]: Dose: 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

[extended-release form]: Dose: 100 mg ER PO qd; Start: 25 mg ER PO qd x1wk, incr. by 25 mg/day qwk; Max: 200 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

sleep-related eating disorder (off-label)

[25-150 mg PO qhs]: Start: 25 mg PO qhs x1wk, then may incr. by 25 mg/day qwk; Info: taper dose gradually to D/C

alcohol dependence (off-label)

[200-300 mg/day PO divided bid]: Start: 25 mg PO qd x1wk, then incr. by 25-50 mg/day qwk; Info: taper dose gradually to D/C

essential tremor (off-label)

[150-300 mg/day PO divided qd-bid]: Start: 25-50 mg PO qhs x1-2wk, incr. by 25 mg/day q1-2wk; Max: 400 mg/day; Info: taper dose gradually to D/C

binge eating disorder (off-label)

[100-150 mg PO bid]: Start: 25 mg PO qd x1wk, incr. by up to 25-100 mg/day qwk; Max: 400 mg/day; Info: taper dose gradually to D/C

cyclic vomiting syndrome prophylaxis, moderate-severe (off-label)

[immediate-release form]: Dose: 50 mg PO bid; Start: 25 mg PO qd, incr. by 25 mg/day qwk; Info: taper dose gradually to D/C

[extended-release form]: Dose: 100 mg ER PO qd; Start: 25 mg ER PO qd, incr. by 25 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; 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

[see below]: hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms: ER CAP: 25 mg, 50 mg, 100 mg, 200 mg; ER SPRINKLE CAP: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg; SPRINKLE CAP: 15 mg, 25 mg; TAB: 25 mg, 50 mg, 100 mg, 200 mg

partial seizures

[monotherapy, immediate-release form, 2-9 yo, <11 kg]: Dose: 75-125 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 12-22 kg]: Dose: 100-150 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 23-31 kg]: Dose: 100-175 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 32-38 kg]: Dose: 125-175 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, >39 kg]: Dose: 125-200 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 10 yo and older]: 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

[monotherapy, extended-release sprinkle cap, 2-9 yo, <11 kg]: Dose: 150-250 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 12-22 kg]: Dose: 200-300 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 23-31 kg]: Dose: 200-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 32-38 kg]: Dose: 250-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, >39 kg]: Dose: 250-400 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, <11 kg]: Dose: 150-250 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 12-22 kg]: Dose: 200-300 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 23-31 kg]: Dose: 200-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 32-38 kg]: Dose: 250-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, >39 kg]: Dose: 250-400 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release form, 10 yo and older]: Dose: 400 mg ER PO qd; Start: 50 mg ER PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg ER PO qd, then incr. by 100 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

[adjunct tx, immediate-release form, 2-16 yo]: Dose: 5-9 mg/kg/day PO divided bid; Start: 1-3 mg/kg/dose up to 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: taper dose gradually to D/C

[adjunct tx, extended-release sprinkle cap, 2-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[adjunct tx, extended-release cap, 6-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open ER cap; taper dose gradually to D/C

seizures, primary generalized tonic clonic

[monotherapy, immediate-release form 2-9 yo, <11 kg]: Dose: 75-125 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 12-22 kg]: Dose: 100-150 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 23-31 kg]: Dose: 100-175 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, 32-38 kg]: Dose: 125-175 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 2-9 yo, >39 kg]: Dose: 125-200 mg PO bid; Start: 25 mg PO qhs x1wk, then 25 mg PO bid x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: taper dose gradually to D/C

[monotherapy, immediate-release form, 10 yo and older]: 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

[monotherapy, extended-release sprinkle cap, 2-9 yo, <11 kg]: Dose: 150-250 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 12-22 kg]: Dose: 200-300 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 23-31 kg]: Dose: 200-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, 32-38 kg]: Dose: 250-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release sprinkle cap, 2-9 yo, >39 kg]: Dose: 250-400 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, <11 kg]: Dose: 150-250 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 250 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 12-22 kg]: Dose: 200-300 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 300 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 23-31 kg]: Dose: 200-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, 32-38 kg]: Dose: 250-350 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 350 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release cap, 6-9 yo, >39 kg]: Dose: 250-400 mg ER PO qd; Start: 25 mg ER PO qhs x1wk, then 50 mg ER PO qd x1wk, then incr. by 25-50 mg/day qwk; Max: 400 mg/day; Info: do not open ER cap; taper dose gradually to D/C

[monotherapy, extended-release form, 10 yo and older]: Dose: 400 mg ER PO qd; Start: 50 mg ER PO qd x1wk, then incr. by 50 mg/day qwk until 200 mg ER PO qd, then incr. by 100 mg/day qwk; Info: may open ER sprinkle cap, but do not crush/chew contents; do not open ER cap; taper dose gradually to D/C

[adjunct tx, immediate-release form, 2-16 yo]: Dose: 5-9 mg/kg/day PO divided bid; Start: 1-3 mg/kg/dose up to 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: taper dose gradually to D/C

[adjunct tx, extended-release sprinkle cap, 2-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[adjunct tx, extended-release cap, 6-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open ER cap; taper dose gradually to D/C

seizures, Lennox-Gastaut syndrome

[adjunct tx, immediate-release form, 2-16 yo]: Dose: 5-9 mg/kg/day PO divided bid; Start: 1-3 mg/kg/dose up to 25 mg PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: taper dose gradually to D/C

[adjunct tx, extended-release sprinkle cap, 2-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: may open ER sprinkle cap, but do not crush/chew contents; taper dose gradually to D/C

[adjunct tx, extended-release cap, 6-16 yo]: Dose: 5-9 mg/kg/dose ER PO qd; Start: 25 mg ER PO qhs x1wk, then incr. by 1-3 mg/kg/day q1-2wk; Max: 400 mg/day; Info: do not open ER cap; taper dose gradually to D/C

migraine prophylaxis

[immediate-release form, 12 yo and older]: Dose: 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

[extended-release form, 12 yo and older]: Dose: 100 mg ER PO qd; Start 25 mg ER PO qd x1wk, incr. by 25 mg/day qwk; Max: 200 mg/day; Info: may open ER sprinkle cap, but do not crush/chew content; do not open ER cap; 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

[see below]: hepatic impairment: not defined, caution advised

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Drugs

Classes

Drug Names

Select a medication above to begin.

topiramate

generic

Drug Monograph

Adult Dosing .

partial seizures

seizures, primary generalized tonic clonic

seizures, Lennox-Gastaut syndrome

migraine prophylaxis

sleep-related eating disorder (off-label)

alcohol dependence (off-label)

essential tremor (off-label)

binge eating disorder (off-label)

cyclic vomiting syndrome prophylaxis, moderate-severe (off-label)

renal dosing

hepatic dosing

Peds Dosing .

partial seizures

seizures, primary generalized tonic clonic

seizures, Lennox-Gastaut syndrome

migraine prophylaxis

renal dosing

hepatic dosing