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NERVOUS SYSTEM › ANTIEPILEPTICS › ANTIEPILEPTICS › Other antiepileptics
topiramate
N03AX11
Forms & Strengths
- Tablets: 25mg, 50mg, 100mg, 200mg
- Capsules: 15mg, 25mg, 50mg, 100mg, 150mg, 200mg
- Sprinkle capsules: 15mg, 25mg
Adult Dosing
- Epilepsy: initial 50mg/day, titrate to 200-400mg/day
- Migraine prophylaxis: 50mg/day, may increase to 100mg/day
- Lennox-Gastaut syndrome: initial 50mg/day, titrate to 200-400mg/day
Pediatric Dosing
- Epilepsy: initial 1-3mg/kg/day, titrate to 5-9mg/kg/day
- Infants >3 months and children <17 years: initial 1.25-2.5mg/kg/day
Indications
- Epilepsy: partial onset seizures, generalized tonic-clonic seizures, seizures associated with Lennox-Gastaut syndrome
- Migraine prophylaxis
- Seizures in patients with epilepsy
Mechanism of Action
- Blocks voltage-dependent sodium channels
- Augments the activity of GABA at the GABA_A receptors
- Antagonizes the AMPA/kainate subtype of the glutamate receptor
Contraindications
- Hypersensitivity to topiramate
- Within 6 months of treatment with metformin due to increased risk of metabolic acidosis
Adverse Reactions
- Dizziness, somnolence, fatigue
- Nausea, diarrhea, taste disturbances
- Weight loss, anorexia, kidney stones
Drug Interactions
- Contraceptives: decreased contraceptive efficacy
- Carbonic anhydrase inhibitors: increased risk of renal stones
- Valproic acid: increased risk of hyperammonemia
Curated Content: Needs Vetting Before Put to Clinical Use