Topiramate: Price, Dosage & Where to Buy

Topiramate is an antiepileptic medicine used mainly to control certain types of seizures. It is also used to prevent migraine in people aged 12 years and older.

Topiramate is available as a generic medicine and is sold under the brand name Topamax. In the United Kingdom, it requires a prescription.

Topiramate is used to treat epilepsy. It may be prescribed on its own for partial-onset seizures or primary generalised tonic-clonic seizures in people aged 2 years and older. It may also be used alongside other epilepsy medicines for partial-onset seizures, primary generalised tonic-clonic seizures, or seizures linked with Lennox-Gastaut syndrome in people aged 2 years and older.

Topiramate is also used to prevent migraine in people aged 12 years and older. It is a preventive treatment, rather than a medicine for stopping a migraine after it has started. The choice of treatment depends on the person’s condition, age and medical history.

The label lists oral capsules and coated-pellet capsules in 15 mg, 25 mg, and 50 mg strengths. The label lists extended-release capsules in 25 mg, 50 mg, 100 mg, 150 mg, and 200 mg strengths.

The label lists oral solution at 25 mg/mL. The label lists tablets, coated tablets, and film-coated tablets in 25 mg, 50 mg, 100 mg, and 200 mg strengths.

The usual starting dose is 25 mg/day nightly for the first week in children aged 2 to 9 years during epilepsy monotherapy titration. The usual starting dose is 25 mg/day to 50 mg/day for adult adjunctive epilepsy treatment. The usual starting dose is 25 mg in the evening during the first week of migraine prevention titration.

The label lists 400 mg/day as the recommended monotherapy dose for adults and children aged 10 years and older. The label lists 100 mg/day as the recommended migraine prevention dose for people aged 12 years and older. Dosing varies by indication, age, kidney function and dialysis.

Topiramate affects several signalling systems in the brain. It helps reduce excessive electrical activity that can lead to seizures. It also strengthens some of the brain’s natural calming signals and reduces the activity of certain signals that can make nerve cells more excitable.

These effects can help lower the likelihood of seizures. They may also reduce the tendency of the brain to develop the changes linked with migraine.

The exact way topiramate prevents migraine is not fully understood. Its effects build up as treatment is adjusted, so medical supervision is needed when starting or changing it.

Topiramate can cause fetal harm during pregnancy. Exposure has been linked with an increased risk of major congenital malformations, including cleft lip or cleft palate, and babies being small for gestational age. Topiramate can also cause metabolic acidosis, which may affect pregnancy and the baby.

Anyone who is pregnant, planning a pregnancy or able to become pregnant should discuss the benefits, risks and possible alternatives with a doctor or pharmacist. Treatment should not be stopped suddenly.

A missed dose means a scheduled dose was not taken at the intended time. General pharmacy advice is to follow the instructions from the prescriber or pharmacist and not to make up a missed dose by taking extra medicine.

Topiramate should not be stopped suddenly, because withdrawal of antiepileptic medicines should be gradual. Repeated missed doses can affect seizure control or migraine prevention, so advice should be sought if missed doses happen often.

Store at 20°C to 25°C and protect from moisture. Dispense capsules in a tight container.

Keep the medicine as directed on the label and out of the reach of children. Any capsule opened and mixed with soft food should be swallowed immediately and not stored for future use.