Pharm

Topiramate

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Topiramate, Topamax

  • Indications
  1. Simple Partial Seizures
  2. Complex Partial Seizures
  3. Generalized Tonic Clonic Seizures
  • Adverse Effects
  • Dose related
  1. Interferes with concentration and memory
    1. Refered to pejoratively by some as "Dopamax"
  2. Confusion
  3. Sedation
  4. Lethargy
  5. Dizziness
  6. Ataxia
  7. Diplopia
  8. Tremor
  9. Nervousness
  10. Fatigue
  11. Depression
  12. Anorexia
  13. Dyspepsia
  • Adverse Effects
  • Other
  1. Nephrolithiasis
  2. Narrow Angle Glaucoma
  • Drug Interactions
  1. Other Seizure medications
  • Dose
  • Adult
  1. Initial: 25-50 mg/day (consider start just qhs)
  2. Increase by 25-50 mg/day increments per week
  3. Target
    1. Adults: 400 mg/day divided bid
    2. Elderly: 200 mg/day divided bid
  4. Maximum dose: 1600 mg/day divided bid
  • Dose
  • Child
  1. Initial: 1-3 mg/kg up to 25 mg PO qhs for 1 week
  2. Increase by 1-3 mg/kg/day to 25 mg increments per week
  3. Target range: 5-9 mg/kg/day divided bid
  • Precautions
  1. Adjust dose if Creatinine Clearance <60 ml/min/sec