CLASS:	Anticonvulsant.
Generic name:
Type:	Anti-seizures

Strengths:

Tables:
25 mg, 100 mg, 200 mg.

Dosages: Actual dosage must be determined by a physician.

Adult

Oral:
Start: 50 mg.
Increases: 50 mg each week for eight weeks, until the dose is 400 mg / day.
Maintenance: N/A
Maximum: 400 mg daily, in 2 divided doses.

NOTE: If CCR < 70 mL / 1. 73 m2, use one half of the usual adult dose.

Children, 2-16 years

Oral:
Start: 5-9 mg / kg / day in two divided dose.
Increases: N/A
Maintenance: N/A
Maximum: N/A

Normal dosage:

Adult: 200 mg daily, in 2 divided doses.

Problems with:
Liver Function: Lower dosage with care, increase as needed.
Kidney Function: Lower dosage with care, increase as needed.

Test:
Before taking: Liver / Kidney.
While taking: Liver / Kidney.

The metabolic breakdown of Topamax will be reduced increasing the duration and intensity of its effects.

Take With: Can be taken with or without food.

Full Benefits: 2 to 3 months before evaluating therapeutic effect.

Missed Dose(s): If within one hour take, if over an hour skip and then continue on your normal schedule.
Never Take a Double Dose

If Stop Taking: Do not stop without consulting your physician and never abruptly are you may develop withdrawal seizures.

Overdose symptoms include: N/A.

Warnings

Patients with hepatic function impairment may have increased Topiramate plasma concentrations and a dosage adjustments may be needed. Avoid alcohol while taking this drug. Use extra caution if you have any liver or kidney impairment. ( The metabolic breakdown of Topamax will be reduced increasing the duration and intensity of its effects ). Topamax may increase the frequency of kidney stones.

IMPORTANT SAFETY INFORMATION
Serious risks associated with TOPAMAX include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis), and hyperventilation (rapid, deep breathing) or fatigue. More severe symptoms of metabolic acidosis could include irregular heartbeat or changes in the level of alertness. Chronic, untreated metabolic acidosis may increase the risk for kidney stones or bone disease. Your doctor may want to do simple blood tests to measure bicarbonate levels.

Other serious risks include increased eye pressure (glaucoma), decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion, and difficulty concentrating. Tell your doctor immediately if you have blurred vision or eye pain.

Patients taking estrogen-containing contraceptives should be asked to report any change in their bleeding patterns. Contraceptive efficacy can be decreased even in the absence of breakthrough bleeding.
Although there was a dose-dependent decrease in EE exposure for doses between 200 mg/day and 800 mg/day, there were no significant dose-dependent changes in EE exposure for doses of 50 mg/day to 200 mg/day. The clinical significance of these changes is not known. The possibility of decreased contraceptive efficacy and increased breakthrough bleeding should be considered in patients taking combination oral contraceptive products with TOPAMAX

Do not take this drug if you are pregnant. ( Only take if the mother's or baby's life is endangered )

Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding.

Do not give this drug to anyone under the age of two years. Only use drug in small doses at first if over sixty and with close monitoring.

Do not use if: You had negative reactions to this drug in the past.

Inform your Doctor if: You had negative reactions to this drug in the past.

Topamax ( Symptoms or Effects )

Common: Anxiety, depression, sedation, speech problems, double vision, abnormalities in vision, decreased appetite, impaired cognition, memory impairment, dizziness, impaired muscular coordination, tingling in the extremities, an unsteady gait, nausea, respiratory infections, or weight loss.

Rare: Weight gain.

See physician always: Anxiety, depression, sedation, speech problems, double vision, abnormalities in vision, decreased appetite, impaired cognition, memory impairment, dizziness, impaired muscular coordination, tingling in the extremities, an unsteady gait, nausea, respiratory infections, weight gain, or weight loss.

See physician if severe:

See physician NOW:

Stop taking and see physician NOW: