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adjustment of the dosing regimen is recommended (see DOSAGE AND ADMINISTRATION).
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1 Dosing may be increased to 100 mg every four to six hours, but the daily dosage should not exceed 400 mg 1 and should be limited to 250 to 300 mg .
Topamax is administered as a racemate and both [-] and [+] forms of both Topamax and M1 are detected in the circulation.
Intramuscular (i.m.) Topamax increases gastric pH during anaesthesia similar to famotidine.
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Topamax was not mutagenic in the following assays: Ames Salmonella microsomal activation test,
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Ask your pharmacist if you have questions about which medicines may cause drowsiness.Topamax may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect.
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If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Topamax while you are pregnant.
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Topamax has not been shown to cause histamine release.
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The volume of distribution of Topamax was 2.6 and 2.9 liters/kg in male and female subjects, respectively,
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Use Topamax with caution in the ELDERLY; they may be more sensitive to its effects.Topamax should not be used in CHILDREN younger than 16 years old;

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