Topamax Dosage

How to Take Topamax

Doses of Topamax work differently in different people. The dose of Topamax should therefore be made on an individual basis, weighing the possible benefit of a higher dose with possible Topamax side effect risks.

It may be helpful to keep track of your seizures and migraines using a seizure log or a migraine journal when you first begin taking Topamax. This will help you know if the medicine is working for you at the dose you are taking.

Topamax Dose – Tablets

Topamax is available in tablet form in single doses of 25 mg, 50 mg, 100 mg, and 200 mg. This medication is taken with a liquid such as water. It can be taken with or without food. It is usually taken twice a day, in the morning and evening. Do not split, chew, or crush these tablets.

Topamax Dose – Sprinkle Capsules

Topamax is available in sprinkle capsule form in single doses of 15 mg and 25 mg. This medication can be swallowed whole with a liquid such as water. It contains small beads of medicine, so it can also be opened up and the beads can be sprinkled over a spoonful of soft food such as applesauce. It is usually taken twice a day, in the morning and evening.

Topamax Dosage for Migraine Prevention

Dose of Topamax
Dose of Topamax
Adults 25 mg/day nightly for the first week, then increased in weekly increments by 25 mg depending on response 100 mg/day given in 2 divided doses


Topamax Dosage for Seizures

The dose of Topamax must be tailored to your body’s individual needs while not exceeding the maximum daily doses. In children, specific Topamax dosages depend upon the child’s weight in kilograms. This is why Topamax dosages for children are listed as mg/kg (or milligrams of Topamax per kilogram of body weight). For patients who are already taking another seizure medication, specific starting and maintenance dosages of Topamax will depend on what seizure medication they are taking and whether or not they are going to continue taking it after they begin taking Topamax. This is why there is a wide dosage range that is used when prescribing Topamax for seizures. Sometimes Topamax is taken as one dose per day. Other times it is taken in 2 separate doses. Follow your doctor’s instructions carefully so that you are taking the correct Topamax dosage for you.


Note: Higher dosages of Topamax may be safe for people with epilepsy; however, doses of higher than 400 mg/day do not appear to work any better than a Topamax dosage of 400 mg/day. Topamax dosages over 1600 mg/day have not been studied. The Topamax dose for seizures is based on many factors including the type of seizures as well as whether or not it being used alone or combination with other seizure medications.

Your Topamax dosage will likely be increased gradually from a single 25 mg dosage the first week to two daily doses of 50 mg in the fourth week. Follow your doctor’s instructions carefully regarding your Topamax dosage.

Topamax Dosage in Children

The Topamax dosage for children should be determined based upon their body weight. It is also determined based upon whether or not the child is currently taking other anti-epileptic medicines. The safety and effectiveness of Topamax for treating seizures in patients younger than age 2 has not been established. For children older than age 2, Topamax is recommended to be taken along with other anti-epileptic drugs, not by itself. The safety and effectiveness of Topamax in preventing migraines in children has not been established.

Topamax Dosage in Older Adults

There does not appear to be a difference in safety and effectiveness of Topamax for people over the age of 65. However, there were not very many elderly adults participating in the Topamax studies that have been done. Because patients over the age of 65 may have other health conditions or may be taking other medicines, they should be closely monitored by a doctor when they begin taking a new medicine and when their dosage is increased. Older adults may need to take a lower Topamax dosage if their kidneys are not working properly.

Topamax Dosage in People with Kidney Problems

Because Topamax is removed from the body by the kidneys, the dosage of this drug may need to be adjusted for people with kidney problems including kidney stones or people who are on dialysis.

Learn more about Topamax and the potential benefits and risks by visiting Topamax Precautions and Warnings.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
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