Topiramate: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: [[antiepileptics]] | ||
*Dosage Forms: | *Dosage Forms: 25mg, 50mg, 100mg, 200mg tabs; 15mg, 25mg caps | ||
*Routes of Administration: | *Routes of Administration: PO | ||
*Common Trade Names: | *Common Trade Names: Topamax | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Partial Seizures=== | |||
*monotherapy | |||
**Dose: 200mg PO bid; Start: 25mg PO BID x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective | |||
*adjunct therapy | |||
**Dose: 100-200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective | |||
===seizures, primary generalized tonic clonic=== | |||
*monotherapy | |||
**Dose: 200mg PO bid; Start: 25mg PO BID x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective | |||
*adjunct therapy | |||
**Dose: 200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective | |||
===Seizures, Lennox-Gastaut=== | |||
*adjunct therapy | |||
**Dose: 100-200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective | |||
===Migraine headache, prophylaxis=== | |||
*50mg PO bid | |||
**Start: 25mg PO qhs x1wk, increase by 25mg/day qwk; Max: 200mg/day | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Excreted in breastmilk | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: CrCl 10-70: decrease dose 50%; CrCl <10: decrease dose 75%; HD: give supplement | ||
*Pediatric: | *Pediatric: | ||
===Hepatic Dosing=== | ===Hepatic Dosing=== | ||
*Adult: | *Adult: not defined; caution advised | ||
*Pediatric: | *Pediatric: | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Unclear, however has activity on voltage-gated sodium channels, calcium channels, GABA-A receptors, and carbonic anhydrase enzymes | |||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Seizure]] | |||
*[[Anticonvulsants]] | |||
*[[Anticonvulsant levels and reloading]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:Neurology]] | |||
Latest revision as of 15:51, 8 March 2021
Administration
- Type: antiepileptics
- Dosage Forms: 25mg, 50mg, 100mg, 200mg tabs; 15mg, 25mg caps
- Routes of Administration: PO
- Common Trade Names: Topamax
Adult Dosing
Partial Seizures
- monotherapy
- Dose: 200mg PO bid; Start: 25mg PO BID x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective
- adjunct therapy
- Dose: 100-200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective
seizures, primary generalized tonic clonic
- monotherapy
- Dose: 200mg PO bid; Start: 25mg PO BID x1wk, increase by 50mg/day qwk until 100mg PO bid, then increase by 100mg/day qwk; Info: doses >400mg/day rarely more effective
- adjunct therapy
- Dose: 200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective
Seizures, Lennox-Gastaut
- adjunct therapy
- Dose: 100-200mg PO bid; Start: 25mg PO QD-bid x1wk, increase by 25-50mg/day qwk; Info: doses >400mg/day rarely more effective
Migraine headache, prophylaxis
- 50mg PO bid
- Start: 25mg PO qhs x1wk, increase by 25mg/day qwk; Max: 200mg/day
Pediatric Dosing
Special Populations
- Pregnancy Rating: D
- Lactation risk: Excreted in breastmilk
Renal Dosing
- Adult: CrCl 10-70: decrease dose 50%; CrCl <10: decrease dose 75%; HD: give supplement
- Pediatric:
Hepatic Dosing
- Adult: not defined; caution advised
- Pediatric:
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of Action
- Unclear, however has activity on voltage-gated sodium channels, calcium channels, GABA-A receptors, and carbonic anhydrase enzymes