Table 3.

Topiramate Dosing Schedule for Epilepsy

Initial Dose		Dose Titration	Recommended Dose
Monotherapy: adults and pediatric patients ≥10 years	50 mg/day in two divided doses	Titrate upward weekly by increments of 50 mg for the first 4 weeks, then 100 mg for weeks 5 and 6.	400 mg/day in two divided doses
Adjunctive therapy: adults with partial-onset seizures or Lennox–Gastaut syndrome	25–50 mg/day	Titrate upward weekly to an effective dose by increments of 25–50 mg.	200–400 mg/day in two divided doses
Adjunctive therapy: adults with primary generalized tonic–clonic seizures	25–50 mg/day	Titrate upward weekly to an effective dose by increments of 25–50 mg.	400 mg/day in two divided doses
Adjunctive therapy: pediatric patients with partial-onset seizures, primary generalized tonic–clonic seizures or Lennox–Gastaut syndrome	25 mg/day (or less, based on a range of 1–3 mg/kg per day nightly for the first week)	Titrate upward at 1- or 2-week intervals by increments of 1–3 mg/kg per day, given in two divided doses; dose titration should be guided by clinical outcome.	5–9 mg/kg per day in two divided doses