Doctors prescribe topiramate oral tablet to prevent migraine headaches and treat seizures in adults and some children. You take it by mouth twice per day.
Topiramate oral tablet is a generic version of the brand-name drug Topamax. Topiramate also comes in sprinkle capsules, but that form isn’t described in this article. To learn more about this form, talk with your doctor.
This article describes topiramate oral tablet’s dosages, its strengths, and details on how to take it. You’ll also find information on cost savings and coupon options for topiramate.
If you want to know more about topiramate oral tablet, see this overview article. It covers details about the drug’s uses, side effects, ways to save on cost, and more.
Topiramate oral tablet comes as follows:
- Form: tablet that you swallow
- Strengths: 25 milligrams (mg), 50 mg, 100 mg, 200 mg
Dosage of topiramate
This article describes the recommended dosages* for topiramate oral tablet.
If your doctor prescribes this medication, you should take the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of topiramate oral tablet without your doctor’s recommendation.
* The drugmaker provides these recommended dosages.
Usual recommended dosages of topiramate in adults
Usually, doctors start by prescribing a low dosage of topiramate oral tablet. Then, they’ll adjust it over time until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of topiramate oral tablet that gives the desired outcome.
Dosage for migraine headaches
Topiramate helps prevent migraine headaches. Typically, you’ll divide the daily dosage by taking one dose in the morning and one at night. Dosages in the following table are in milligrams (mg).
If you start having side effects, talk with your doctor about how to slowly and safely increase your dose.
You’ll take a maintenance dosage for the remainder of your treatment, often after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) Your maintenance dosage will be 100 mg per day or a dosage you can tolerate. It will also help manage your symptoms. You’ll continue dividing it into doses to take one in the morning and one at night.
Dosage for seizures
Topiramate treats the following conditions:
- seizures in epilepsy that cause you to lose consciousness
- seizures in epilepsy where you remain aware of your surroundings
- a type of epilepsy called Lennox-Gastaut syndrome
Primary treatment for seizures
Your doctor may prescribe topiramate as your primary treatment for seizures. Below are typical doses of topiramate prescribed on its own to treat seizures. Typically, you’ll divide the daily dosage to take one dose in the morning and one at night.
You’ll take a maintenance dosage for the remainder of your treatment, often after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) Your maintenance dosage will be 400 mg per day. You’ll continue dividing it into doses to take 200 mg in the morning and 200 mg at night.
Add-on treatment for seizures
Your doctor may prescribe topiramate as an add-on to treat your seizures. That means you’ll take it along with another drug for your condition. For example, topiramate may be prescribed with another seizure drug called levetiracetam.
Topiramate’s dosage for this use will be as follows. Typically, you’ll divide the daily dosage to take one dose in the morning and one at night.
- Starting dosage: 25–50 mg per day, divided into doses to be taken in the morning and at night
- Dosage increase: 25–50 mg per day each week
- Maintenance dosage: 200–400 mg per day or the dosage that manages your symptoms
- Maximum dosage: 400 mg per day, divided into doses to be taken in the morning and at night
You’ll take a maintenance dosage for the remainder of your treatment, usually after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) You’ll continue dividing it into doses to take one in the morning and one at night.
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Topiramate is approved for the following purposes in certain children:
Dosage for migraine headaches
Topiramate helps prevent migraine headaches in children ages 12 years and older. (It’s not approved for this use in children younger than age 12 years.) Typically you’ll divide the daily dosage by having your child take one dose in the morning and one at night. Dosages in the following table are in milligrams (mg).
If your child starts having side effects, talk with their doctor about how to slowly and safely increase the dose.
Your child will take a maintenance dosage for the remainder of their treatment, often after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) Your child’s maintenance dosage will be 100 mg per day or a dosage they can tolerate. It will also help manage your child’s symptoms. You’ll continue dividing it into doses for your child to take one in the morning and one at night.
Dosage as primary treatment for seizures
Topiramate is approved as a primary treatment for seizures in children ages 2 years and older.
Children ages 2–9 years
Below are typical doses of topiramate prescribed on its own to treat seizures in children ages 2–9 years. Typically, you’ll divide the daily dosage by having your child take one dose in the morning and one at night.
- Starting dosage, week 1: 25 mg per day, taken at night
- Starting dosage, week 2: 50 mg per day, divided into doses to be taken in the morning and at night
- Dosage increase, weeks 3–7: increase by 25–50 mg per day each week until symptoms are managed
Minimum and maximum maintenance dosages for children ages 2–9 years are shown in the table below. Your child will take a maintenance dosage for the remainder of their treatment, usually after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) These minimum and maximum dosages depend on your child’s weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb).
For example, assume a doctor prescribes topiramate for a child weighing 15 kg (about 33 lb). The child’s minimum daily dosage would be 200 mg. Their maximum daily dosage would be 300 mg. The child’s actual dosage likely would be between 200 mg and 300 mg. This depends on how well it works without causing side effects.
Children ages 10 years and older
Below are typical doses of topiramate prescribed on its own to treat seizures in children 10 years and older. Typically, you’ll divide the daily dosage by having your child take one dose in the morning and one at night.
Your child will take a maintenance dosage for the remainder of their treatment, often after a starting dosage. Your child’s maintenance dosage will be 400 mg per day or a dosage they can tolerate. It will also help manage your child’s symptoms. You’ll continue dividing it into doses for your child to take 200 mg in the morning and 200 mg at night.
Dosage as an add-on treatment for seizures
Your child’s doctor may prescribe topiramate as an add-on to treat their seizures. That means they’ll take it along with another drug for their condition. This use is for children ages 2–17 years and older.
Children ages 2–16 years
Topiramate is prescribed as an add-on seizure treatment in children ages 2–16 years.
Your child will take the starting dosage once at night. After that, you’ll divide the daily dosage by having your child take one dose in the morning and one at night.
- Starting dosage: 1 mg per kg* (mg/kg) to 3 mg/kg per day, taken at night
- Maximum starting dosage: 25 mg per day, taken at night
- Dosage increase: 1–3 mg/kg per day each week, divided into doses to be taken in the morning and at night
- Maintenance dosage: 5–9 mg/kg per day, divided into doses to be taken in the morning and at night
- Maximum dosage: 400 mg per day
* For reference, 1 kg is about 2.2 lb.
Your child will take a maintenance dosage for the remainder of their treatment, often after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.)
Children ages 17 years and older
Topiramate is prescribed as an add-on seizure treatment in children ages 17 years and older.
Topiramate’s dosage for this use will be as follows. Typically, you’ll divide the daily dosage by having your child take one dose in the morning and one at night.
- Starting dosage: 25–50 mg per day, divided into doses to be taken in the morning and at night
- Dosage increase: 25–50 mg per day each week
- Maintenance dosage: 200–400 mg per day or a dosage they can tolerate, which manages their symptoms, divided into doses to be taken in the morning and at night
- Maximum dosage: 400 mg per day, divided into doses to be taken in the morning and at night
Your child will take a maintenance dosage for the remainder of their treatment, usually after the starting and titration dosages. (Titration is a series of increasing or decreasing dosages.) You’ll continue dividing it into doses for your child to take one in the morning and one at night.
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Get free cardDosage adjustments for topiramate
Your doctor will prescribe a dosage of topiramate oral tablet based on several factors. These include:
- the specific condition being treated and its severity
- your age
- other health conditions you may have
- other medications you may take
- your kidney function
Missed dose of topiramate
Talk with your doctor or pharmacist right away if you realize you forgot to take a dose of topiramate oral tablet. They may advise you to take the missed dose. Or they may advise you to skip it and take your next dose as scheduled.
For tips on how to plan your doses of topiramate oral tablet and avoid missing a dose, read this article. You could also try:
- downloading a reminder app on your phone
- setting an alarm
- putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table
Frequently asked questions
Below are answers to some commonly asked questions about topiramate oral tablet and its dosage.
Can topiramate be taken for weight loss or nerve pain? If so, what is the dosage?
It might be. Topiramate is taken with the drug phentermine for weight loss. The brand name of this two-drug combination is Qsymia.
Doctors sometimes prescribe topiramate off-label for nerve pain. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved to treat.
To learn more about these conditions, Qsymia, or taking topiramate off-label, talk with your doctor.
What is the best time of day to take topiramate?
You’ll typically take topiramate twice per day. You should plan to take your doses in the morning and at night.
Ask your doctor how best to schedule your daily topiramate doses.
Is topiramate taken long term?
Yes, doctors typically prescribe topiramate oral tablet as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
If you have questions about how long you should take topiramate oral tablet, talk with your doctor.
How topiramate is taken
You’ll take topiramate oral tablet by swallowing it, usually twice per day. You should not crush or chew topiramate tablets as they have a bitter taste. You can ask your doctor or pharmacist whether it’s safe for you to split the tablets.
You may take the tablets with or without food.
Your doctor may advise that you take this medication around the same time each day. This can help the drug work more effectively. That’s because you’re keeping a consistent amount of the drug in your body.
If it’s hard for you to swallow tablets, view this article. It provides suggestions on how to swallow medications that come in pill form.
Also, be sure to talk with your doctor or pharmacist if you’re having difficulty taking your medication. They can offer recommendations about taking it.
Topiramate coupon
Visit this page to access Optum Perks coupons and get price estimates for topiramate when you use the coupons. These coupons can provide significant savings on your prescription costs.
Note: Optum Perks coupons cannot be used with any insurance copays or benefits.
Overdose of topiramate
It’s important that you do not take more topiramate oral tablet than your doctor prescribes. Doing so can lead to serious side effects.
Symptoms of topiramate overdose
Symptoms of an overdose can include:
What to do if you take too much topiramate
If you think you’ve taken too much topiramate, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
What to ask your doctor
This article describes the usual recommended dosages for topiramate oral tablet. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.
Do not change your dosage of topiramate oral tablet without your doctor’s recommendation. You should take topiramate oral tablet exactly as your doctor prescribes it. Let your doctor know if you have concerns or questions about your treatment plan.
Here’s a list of some possible questions you may want to ask your doctor:
- Will my topiramate dosage be lower if I have kidney problems?
- How quickly will my topiramate dosage increase once I start treatment?
- Does it matter what time of the morning or evening I take my topiramate dosage?
- Will a lower topiramate dosage have a lower risk of side effects?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
