Topamax expiration dating shelf life

General When concomitant AEDs are withdrawn to achieve monotherapy with topiramate, consideration should be given to the effects this may have on seizure control.Unless safety concerns require an abrupt withdrawal of the concomitant AED, a gradual discontinuation at the rate of approximately one-third of the concomitant AED dose every 2 weeks is recommended.The dosage should then be increased at 1 or 2 week intervals by increments of 0.5 to 1 mg/kg/day, administered in two divided doses.

On rare occasions, the addition of topiramate to phenytoin may require an adjustment of the dose of phenytoin to achieve optimal clinical outcome.The dosage should then be increased at 1- or 2-week intervals by increments of 1 to 3 mg/kg/day (administered in two divided doses), to achieve optimal clinical response.Daily doses up to 30 mg/kg/day have been studied and were generally well tolerated.Some patients with refractory forms of epilepsy have tolerated topiramate monotherapy at doses of 1,000 mg/day.These dosing recommendations apply to all adults including the elderly in the absence of underlying renal disease.The dosage should then be increased at 1- or 2-week intervals by increments of 25 or 50 mg/day, administered in two divided doses.If the patient is unable to tolerate the titration regimen, smaller increments or longer intervals between increments can be used.Use of lower initial doses has been reported, but has not been studied systematically.Subsequently, at weekly or bi-weekly intervals, the dose should be increased by 25-50 mg/day and taken in two divided doses.Adults The recommended total daily dose of topiramate for prophylaxis of migraine headache is 100 mg/day administered in two divided doses.The dosage should then be increased in increments of 25 mg/day administered at 1-week intervals.

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