Topiramate is a miscellaneous anticonvulsant and a carbonic anhydrase inhibitor. It can decrease and prevent the spread of abnormal electrical signals in the brain to prevent migraine and treat various types of seizures, including primary generalized tonic-clonic seizures, partial seizures and seizures associated with Lennox-Gastaut.
Topiramate can be taken orally as tablets or sprinkle capsules. The tablets should not be crushed or chewed, where the sprinkle capsules can be opened and sprinkled the entire contents on a small amount (teaspoon) of soft food. This drug-food mixture should be swallowed immediately and not chewed.
Listed below are the indication and the dosages, which patients with poor renal function may need a lower dose.
Monotherapy for partial seizures and primary generalized tonic-clonic seizures:
Patients 10 years of age and older:
Initial: 25 mg twice daily, and increased by 25 mg/dose every week up to 100 mg twice daily. Then, it may further be increased by 100 mg/dose every week.
Maintenance: 200 mg twice daily.
Pediatrics patients 2 – 9 years:
Initial: 25 mg once daily in the evening for the 1st week, and increased to 25 mg twice daily in the 2nd week. Then, it may further by 25-50 mg/day at weekly intervals over 5-7 weeks
11 kg: 150 – 250 mg/day in two divided doses.
12 – 22 kg: 200 – 300 mg/day in two divided doses.
23 – 31 kg: 200 – 350 mg/day in two divided doses.
32 – 38 kg: 250 – 350 mg/day in two divided doses.
> 38 kg: 250 – 400 mg/day in two divided doses.
Adjunctive therapy for partial seizures, primary generalized tonic-clonic seizures, and Lennox-Gastaut syndrome:
Patients 17 years of age and older:
Initial: 25-50 mg/day, and increased by 25-50 mg/day every week.
Maintenance: 200 mg twice daily.
Pediatrics patients 2 – 16 years:
Initial: 1-3 mg/kg/day once daily in the evening for the 1st week, and increased in 1-3 mg/kg/day increments every 1-2 week in two divided doses.
Maintenance: 5-9 mg/kg/day in two divided doses, without exceeding the maximum
Maximum: 400 mg/day
Prevention of Migraine:
Patients 12 years of age and older
Initial: 25 mg once daily in the evening, and increased by 25 mg/dose every week.
Maintenance: 50 mg twice daily.
Common dosing schedule:
This schedule is for reference only, adjustments may be made according to individual needs.
Some common medications Topiramate may interact with:
Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.
In Hong Kong, Topiramate is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.
For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk
Need more information?
For detailed information about the use of Topiramate in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.
Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.