Neurology · Multi-mechanism antiseizure
Topiramate
Dose
Start 25 mg nocte; increase 25 mg weekly to 100–200 mg/day in 2 divided doses.
Use
Focal/generalised epilepsy and migraine prophylaxis.
Monitoring
Bicarbonate (metabolic acidosis), weight, cognition, renal stones.
Side effects
- • Word-finding difficulty
- • Paraesthesia
- • Weight loss
- • Renal stones
- • Acute myopia/glaucoma
Pregnancy safety
Avoid — cleft lip/palate risk; ensure effective contraception.
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
