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The usual total daily dose is 200 mg to 400 mg in two divided doses. Some patients may require doses up to 800 mg per day which is the maximum dose. It is recommended that therapy be initiated at a low dose, followed by titration to an effective dose.
For children 10 years or older and adults the dose may be increased by 100 mg in week 5 and 6 when topiramate is used alone. This slow approach to treatment reduces side effects. The recommended final adult dose is 200-400 mg administered as two divided doses daily.