Topiramate

Introduction

Topiramate is a medication used to treat epilepsy and prevent migraines. For epilepsy this includes treatment for generalized or focal seizures. It is also used as adjunctive treatment for seizures associated with Lennox-Gastaut syndrome.

Generic Name 藥名	HA Code 藥物代碼	Classification藥物分類
Topiramate Tablet 25 mg	TOPI01	P1S1S3
Topiramate Tablet 50 mg	TOPI01	P1S1S3
Topiramate Tablet 100 mg	TOPI03	P1S1S3

Mechanism of Action

Anticonvulsant medication. It inhibits the sodium channels, calcium channels, GABA-A receptors, and carbonic anhydrase isoenzymes, contributing to the antiseizure effects.

Dosage

For both adjunctive and monotherapy of epilepsy	By mouth ADULT: Initial dose of 25 to 50 mg at night for 1 week; then Increased by increments of 25 or 50 mg at intervals of 1 to 2 weeks until the effective dose is reached. Daily doses of more than 25 mg should be taken in 2 divided doses. The usual daily dose for adjunctive therapy is 200 to 400 mg When used as monotherapy, usual doses range from 100 mg daily to a maximum of 500 mg daily. Doses in children, for use as adjunctive therapy in children aged 6 years and over, and as monotherapy in those aged 12 years or over. 6-12 years (adjunctive therapy): initially 10 mg/kg (max. 300 mg) once daily on day 1, then 10 mg /kg (max. 300mg) twice daily on day 2, then 10mg mg/kg (max. 300 mg) 3 times daily on day 3; Usual dose 25 – 35 mg/kg daily in 3 divided doses; Max. 70 mg/kg daily in 3 divided doses.
Neuropathic Pain	By mouth: 300 mg once daily on day 1, then 300 mg twice daily on day 2, then 300 mg 3 times daily on day 3. Alternatively, 300 mg 3 times daily on day 1, then increased according to response in steps of 300mg (in 3 divided doses) every 2-3 days up to max. 3.6 g daily.
Migraine prophylaxis	By mouth: initially 300 mg daily, increased according to response up to 2.4 g daily in divided doses.