seizure medication

If I take 50mg of topramax at5am and100mg at 8pm,but i forget my 5am med and i don't get home until4pm what do i do?

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not give you specific medication recommendations. However I will try to provide you with some useful information.

In general, medications are divided in specific dosing schedules, such as twice a day, so that a certain level can be maintained over a 24 hour period. With a missed dose, the levels may be lower during the hours subsequent to that. Sometimes, with certain medications, it is recommended that a missed dose be taken as soon as possible. With topamax, if it is being taken for migraines or pseudotumor cerebri, missing one dose is not detrimental, and that dose can just be skipped, and the next regular dose taken. For seizures, it is also not detrimental,  but dropping levels is more relevant as seizures can occur, so doses should not be missed, and if missing doses starts to occur too frequently, then medications should be adjusted or changed so that once-daily dosing or dosing at more convenient intervals can occur.

Continued followup with your neurologist is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.