Initially 25 mg nightly for 1 wk, then should be increased at 1-2 wk intervals by increments of 25 or 50 mg/day in 2 divided doses. Recommended dose: 100-500 mg/day. Some patient w/ refractory forms of epilepsy have tolerated topiramate monotherapy at doses of 1,000 mg/day. Dosing recommendations applicable to all adults including the elderly in the absence of underlying renal disease. Childn ≥2 yr
Initially 0.5-1 mg/kg nightly for the 1st wk, then should be increased at 1-2 wk intervals by increments of 0.5-1 mg/kg/day in 2 divided doses. Recommended dose: 100-400 mg/day. Childn w/ recently diagnosed partial onset seizures have received doses of up to 500 mg/day. Adjunctive therapy Adult
Same as monotherapy. Usual daily dose: 200-400 mg in 2 divided doses. Childn >2 yr
Begin at 25 mg (or less) nightly for 1st wk, then dose should be increased at 1-2 wk intervals by increments of 1-3 mg/kg/day in 2 divided doses. Recommended total daily dose: 5-9 mg/kg/day in 2 divided doses. Daily doses up to 30 mg/kg/day have been studied & were generally well tolerated. Migraine
Titrate initially w/ 25 mg every night for 1 wk. Increase by 25 mg/day at 1-wk interval. Use longer intervals between dose adjustment if patient cannot tolerate titration schedule. Prevention of migraine
100 mg/day in 2 doses. Total daily dose 50-200 mg/day depending on patient response. Dosage rate & titration should be clinically monitored.