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In monotherapy trials for patients 6 to 15 years, the incidence of persistent decreases in serum bicarbonate was 9% for 50 mg per day and 25% for 400 mg per day. The dosage also depends on the patient's age, the severity of the medical condition, and other medical conditions. If you are pregnant, you should talk to your healthcare provider. Patients were randomized to placebo, phentermine 3.75 mg/topiramate 23 mg (starter dose), phentermine 7.5 mg/topiramate 46 mg (recommended dose), or phentermine 15 mg/topiramate 92 mg (top dose). In these trials, it was recommended that patients eat a well-balanced diet and reduce their caloric intake by 500 kcal/day. 1,2 The capsule is available in 15 mg and 25mg. The dosage varies with the person's condition and age. 1. Topamax has both approved and off-label uses. The U.S. Food and Drug Administration (FDA) has approved it for: 2. Migraine prevention in adults and adolescents 12 and older. 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