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Dosing - Discontinuation or Withdrawal of TOPAMAX Therapy
Last Updated: 09/11/2026
In patients with or without a history of seizures or epilepsy, antiepileptic drugs, including TOPAMAX® , should be gradually withdrawn to minimize the potential for seizures or increased seizure frequency. In situations where rapid withdrawal of TOPAMAX® is medically required, appropriate monitoring is recommended.1
Please refer to the following sections of the Full Prescribing Information1 that are relevant to your inquiry: WARNINGS AND PRECAUTIONS and CLINICAL STUDIES.
As stated in the CLINICAL STUDIES section:
Epilepsy
In clinical trials for epilepsy, daily dosages were decreased in weekly intervals by 50 to 100 mg/day in adults and over a 2- to 8- week period in pediatric patients; transition was permitted to a new antiepileptic regimen when clinically indicated.
Migraine
For patients withdrawing from TOPAMAX®, daily dosages were decreased in weekly intervals by 25 to 50 mg/day.
References
| 1 | TOPAMAX (topiramate) [Prescribing Information]. Titusville, NJ: Janssen Pharmaceuticals, Inc; https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/TOPAMAX-pi.pdf. |
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