What is Topamax for migraines? Topamax recommended dosage and costs. Topomax Generic topiramate Oral capsule: 15 mg and 25 mg Oral capsule: 15 mg and 25 mg Oral tablet: 25 mg, 50 mg, mg, mg Oral tablet: 25 mg, 50 mg, mg, mg.
How long does Topamax take to work. Side effects of Topamax. Effectiveness of Topamax. Talk with your doctor. Does Botox Treat Chronic Migraine? Read this next. Medically reviewed by Deena Kuruvilla, MD. Medically reviewed by Natalie Olsen, R. Medically reviewed by Deborah Weatherspoon, Ph. Medically reviewed by Tiffany Taft, PsyD. Does Physical Therapy Treat Migraine? Overview of Migraine in Children.
Medically reviewed by Mia Armstrong, MD. Medically reviewed by Alan Carter, Pharm. For example, the drug may cause agitation, aggression , or other behavior problems. Topamax may also cause mood changes, such as anxiety , mood swings , and depression. In addition, the medication may raise your risk for suicidal thoughts or behaviors. All antiepileptic drugs medications used to treat seizures due to epilepsy are known to slightly raise the risk of suicidal thoughts and behaviors.
Clinical studies looked at people taking an antiepileptic drug for any condition. The people had about twice the risk of suicidal thoughts or behaviors than people taking a placebo. In these studies, suicidal behavior or thoughts occurred in:.
These symptoms can include:. If you have any symptoms of new or worsening depression while taking Topamax, talk with your doctor right away. They can suggest ways to ease this condition. They may also recommend that you switch to a different medication.
If you need to stop taking Topamax, your doctor will explain how to taper off the drug gradually. However, weight gain has been reported with some anticonvulsant drugs that are in the same class as Topamax. A drug class is a group of medications that work in a similar way. Topamax can cause weight loss.
However, the drug may reduce your appetite, which may lead you to lose weight. This depended on the dosage and condition treated. One review of studies looked at the average weight loss in people who took Topamax. It also looked at how long it took them to lose weight when they took the drug. People who took Topamax for at least 4 months lost an average of But your doctor might recommend Topamax for preventing seizures or migraine if you would also benefit from weight loss.
You should take it as prescribed by your doctor for seizures or migraine. Note: Weight loss is an approved use for the brand-name medication Qsymia. Qysmia contains topiramate the active drug in Topamax with another drug called phentermine. The drug is also approved for use in people who are overweight and have an increased risk of health problems. These can include conditions such as high blood pressure , high cholesterol , and type 2 diabetes.
Typically, your doctor will start you on a low dose. Your doctor will ultimately prescribe the smallest dose that provides the desired effect. The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs. The usual recommended dosage is 50 mg taken once in the morning and once in the evening. Your doctor will gradually increase your dosage to this level over the first 4 weeks of treatment.
This allows your body to get used to the medication and helps reduce the frequency and severity of side effects. Topamax is used to treat epilepsy a condition that causes repeated seizures in certain situations. The dosage of Topamax is gradually increased over the first few weeks of treatment.
Topamax can be used on its own to treat partial-onset seizures and generalized tonic-clonic seizures. The usual recommended dosage for treating these types of seizures is mg twice per day. The drug should be taken once in the morning and once in the evening for a total of mg per day. This is the dosage for both adults and children ages 10 years and older. Topamax can be used with other seizure medications to treat partial-onset seizures, generalized tonic-clonic seizures, and seizures linked to Lennox-Gastaut syndrome LGS.
LGS is a rare form of childhood epilepsy that causes several different types of seizures. For the first week of treatment, the starting dosage is usually 25 mg to 50 mg per day.
After this, your doctor may increase your daily dosage by 25 mg to 50 mg each week until the recommended dosage is reached. The usual recommended dosages for treating these types of seizures in adults ages 17 years and older are:.
The recommended dose per day is split into two equal doses. One dose is taken in the morning and the other is taken in the evening.
Topamax is used to treat certain seizures in children ages 2 years and older. The usual recommended dosage of Topamax in children ages 12 years and older is the same as it is for adults. For children ages 10 years and older, the usual recommended dosage of Topamax is the same as it is for adults. Below is information for treating children ages 2 to 9 years. For the first week of treatment, the starting dosage is 25 milligrams mg taken every evening. If your child tolerates this well, for the second week of treatment, their doctor may increase the dosage to 25 mg twice per day.
This is a total of 50 mg daily. This will take place over the first few weeks until the recommended dose is reached. After this, their doctor may increase their daily dosage by 25 mg to 50 mg each week. This is done until your child is at the minimum recommended dose for their body weight. This increase will continue until your child is at the maximum dose for their body weight.
For children ages 2 to 9 years, the usual recommended dosage of Topamax is based on body weight as follows:. Children ages 17 years and older typically take the same dosage of Topamax as adults.
The following sections discuss the dosages for children ages 2 to 16 years. For the first week of treatment, the starting dose per day is usually about 1 milligram mg to 3 mg per kilogram kg of body weight. Topamax is typically taken as a single dose every evening. This allows their body to get used to the medication and helps reduce the frequency and severity of side effects.
The medication is split into two equal doses. The daily dose is increased until your child is at the minimum recommended dose for their body weight. For children ages 2 to 16 years, the usual recommended daily dose is 5 mg to 9 mg per kg of body weight. The recommended daily dose is split into two equal doses. One dose is taken in the morning, and the other dose is taken in the evening.
Take your next dose at your usual time. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too. Topamax is meant to be used as a long-term treatment. You should avoid drinking alcohol with Topamax. Drinking alcohol during Topamax treatment can increase the frequency and severity of Topamax side effects, such as:.
In serious cases, drinking alcohol with Topamax may lead to serious side effects. These may include slow, shallow breathing, loss of consciousness, coma, and in rare cases, death. Topamax is more likely to make you feel sleepy, low in energy, or a bit dazed and confused. You may also have trouble with concentration, memory, or speech while taking it. Topamax has a half-life of about 21 hours. The half-life of a drug is the time it takes for the amount of the drug in your body to fall by half.
It takes about five half-lives for a drug to be almost completely removed from your body. So for Topamax, most of the drug will be flushed out of your system within about 5 days after you stop taking it. Controlled substances are drugs that have certain effects that give them a high potential for being misused. They also have a high risk of leading to drug dependence.
Because of these risks, there are special rules about how controlled substances are prescribed and dispensed. Mood stabilizers are drugs that help prevent extreme changes in mood, such as those that occur with bipolar disorder. People with bipolar disorder typically have episodes of depression and episodes of mania. Mania is a mood disorder that gives you an unnatural feeling of physical and mental energy. Several anticonvulsant medications also work as mood stabilizers in people with bipolar disorder.
Topamax, which is an anticonvulsant medication, is sometimes used in this way. Anticonvulsants are also called antiepileptic drugs. Anticonvulsants are mainly used to treat epilepsy a condition that causes repeated seizures. These include migraine and nerve pain. However, once Topamax controls your condition, you will need to keep taking it to continue to prevent seizures or migraine.
If you stop taking Topamax, your seizures or migraine headaches may happen more often. They could also become more severe. Sometimes people without epilepsy have had seizures after suddenly stopping Topamax. If you and your doctor decide to stop treatment, you may need to stop taking Topamax gradually. This can help reduce your risk for seizures. Topamax can interact with several other medications. It can also interact with certain foods. Different interactions can cause different effects.
For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Below are examples of medications that can interact with Topamax. Before taking Topamax, talk with your doctor and pharmacist.
Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Topamax can make birth control drugs that contain estrogen less effective at preventing pregnancy. Topamax treatment can also make certain birth control medications less effective at preventing pregnancy.
These include:. If you use birth control that contains estrogen, your doctor may recommend switching to a different type of birth control medication while you take Topamax. Taking Topamax with phenytoin Dilantin or carbamazepine Tegretol can lower the level of Topamax in your blood. This could make Topamax less effective at preventing seizures or migraine headaches.
If you need to take Topamax with phenytoin or carbamazepine, your doctor may prescribe a higher dosage of Topamax. Clinical trials and experience with topiramate have not identified serious safety concerns.
Topiramate markedly lowers serum bicarbonate levels in 10 percent of patients, 1 but this is clinically significant only in patients with other risk factors for metabolic acidosis. In three large randomized controlled trials 2 — 4 in which collectively almost 1, patients received topiramate,10 patients reported renal calculi, and for three of these patients this resulted in discontinuation of the medication.
Topiramate is FDA pregnancy category C, and is excreted in breast milk. Topiramate is not tolerated well by some patients. The most common side effects of topiramate compared with placebo are paresthesias 51 versus 6 percent, respectively , fatigue 15 versus 11 percent , nausea 13 versus 8 percent , and difficulty with memory, concentration, or language 15 versus 5 percent. Patients who received mg of topiramate per day lost about 3 percent of their body weight.
Topiramate has been studied in patients age 12 to 65 years who had an average of 5. At a dosage of 50 mg twice per day, topiramate reduced migraine frequency by approximately two headaches per month compared with a reduction of one headache per month with placebo.
A Cochrane review 5 of anticonvulsants for migraine prevention, which included topiramate, showed that anticonvulsants as a class reduced migraine frequency by 1. Topiramate has not been directly compared with other anti-epileptic drugs, tricyclic antidepressants, or calcium channel blockers.
However, one study 4 included propranolol Inderal as an active control. Topiramate and propranolol had similar efficacy, decreasing migraine frequency by 1. The recommended dosage of topiramate for migraine prevention is 50 mg twice per day. Patients should start with 25 mg once per day, then increase by 25 mg per week up to the recommended dosage. The dosage should be halved for patients with renal impairment i. Topiramate is more effective than placebo for migraine prevention.
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