TheraRadar
Data updated: Mar 29, 2026

TOPIRAMATE

TOPIRAMATE Cytochrome P450 3A4 Inducers
Neurology Approved 2003-12-17

Topiramate is an anticonvulsant indicated for the treatment of epilepsy and the preventive treatment of migraine. It is approved as initial monotherapy for partial-onset or primary generalized tonic-clonic seizures in patients aged 2 years and older. It is also indicated as adjunctive therapy for partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome in patients aged 2 years and older. Additionally, topiramate is indicated for the preventive treatment of migraine in patients 12 years of age and older.

Source: FDA Label โ€ข ACCORD HLTHCARE

How TOPIRAMATE Works

The precise mechanisms by which topiramate exerts its effects are unknown, though preclinical studies suggest four properties contribute to its efficacy. At pharmacologically relevant concentrations, the drug blocks voltage-dependent sodium channels, augments the activity of the neurotransmitter gamma-aminobutyrate (GABA) at specific GABA-A receptor subtypes, and antagonizes the AMPA/kainate subtype of the glutamate receptor. Additionally, topiramate inhibits the carbonic anhydrase enzyme, particularly isozymes II and IV.

Source: FDA Label
34
Indications
--
Phase 3 Trials
22
Years on Market

TOPIRAMATE Approval History

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What TOPIRAMATE Treats

4 indications

TOPIRAMATE is approved for 4 conditions since its original approval in 2003. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Partial-onset seizures
  • Primary generalized tonic-clonic seizures
  • Seizures associated with Lennox-Gastaut syndrome
  • Preventive treatment of migraine
Source: FDA Label

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Active Pipeline

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Ongoing clinical trials by development phase

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Key Completed Trials

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Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

TOPIRAMATE FDA Label Details

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Indications & Usage

Topiramate tablets are indicated for: Epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older ; adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome in patients 2 years of age and older Preventive treatment of migraine in patients 12 years of age and older 1.1 Monotherapy Epilepsy Topiramate tablets are indicated as initial monotherapy for the treatment of partial-onset or primary generalized tonic-c...

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.