Question: Going from 50 mg of Topamax to 400 mg overnight?
Answer:
Full Question:
Topamax for migraine: started taking 25mg for 1
week, 2nd week went up to 50mg, stayed at that dose for 3 weeks. Doctor now
wants me to go to 400 mg starting today or as soon as pharmacy can get the 200mg
pills in, one 200mg in the morning and one 200mg at night. Pharmacist has never
heard of anyone going 50mg to 400mg over night and called my doc to question
him. Package info say 25mg increased every week until you get to your dose. Who
is right here doctor, pharmacist or drug company? Thanks, Y.
Answer:
Dear Y.;
There is seldom one right answer on medication dosages, but information about Topamax titration is pretty clear. Topamax need to be increased gradually. This helps avoid side effects and avoid the infrequent complication of the medication actually causing seizures in sensitive patients. The dosage information from the pharmaceutical company is based on clinical trials of medications. It's generally accepted that Topamax titration should be gradual.
Have you talked with your doctor about this? Perhaps he meant for you to taper up to the higher dosage.
Good luck,
Teri Robert and John Claude Krusz
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Published January 9, 2006
