Toprex

by L' A Kurative

Active ingredient: Topiramate

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About Topiramate

Anti-epileptic

Uses

Adjunctive therapy for partial seizures, with or without secondary generalized seizures, Lennox Gastaut syndrome and primary generalized tonic clonic seizures in patients inadequately controlled by other anticonvulsants. Migraine prophylaxis. Monotherapy of generalized tonic-clonic seizures or focal seizures with or without secondary generalization.

How to take it

Adults: Monotherapy of generalized tonic-clonic seizures or focal seizures with or without secondary generalization: Initially 25 mg once daily at night for 1 wk, increased in steps of 25-50 mg in 2 divided doses every 1-2 wks, usual dose 100-200 mg daily in 2 divided doses, adjusted according to response, 1 gm daily dose have been used in refractory epilepsy, max 500 mg daily. Adjunctive treatment: Initially 50 mg daily for one wk, then increase by 50 mg in two divided doses daily at wkly intervals Usual maintenance, 200-400 mg daily in two divided doses; max 400 mg daily. Use lower dose and longer interval between increments if patient is unable to tolerate titration regimen. Migraine…

Side effects

Ataxia, difficulty concentrating, confusion, dizziness, fatigue, paraesthesia, somnolence, emotional lability, depression, CNS disturbances, headache, asthenia, sedation, wt change, GI upset, dry mouth, anorexia, insomnia, dysgeusia, speech and visual disturbances, nystagmus, cognitive disorders, convulsions, tremor, anxiety, hypoaesthesia, mood changes, agitation, abnormal behaviour, tinnitus, ear pain, dyspnoea, impaired balance and coordination, arthralgia, myalgia, muscle spasm, anaemia, nasal congestion, rhinorrhoea, epistaxis, cough, nephrolithiasis, pollakiuria, dysuria, alopecia, rash, pruritus, pyrexia. Rarely, acute myopia with secondary angle-closure glaucoma.

Pregnancy and breastfeeding

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Precautions: Renal or hepatic impairment. Patients at risk of nephrolithiasis; maintain adequate hydration. History of eye disorders. Monitor patients for signs of depression and suicidal thoughts. Risk factors for metabolic acidosis; monitor serum bicarbonate and reduce dose or withdraw if occurs. Monitor for wt loss. Withdraw gradually.

Advice

Take with or without meals. Do not chew or crush tablets, swallow whole. Do not stop taking medication abruptly, gradually lower the dose and then stop. Contact prescriber if there is change in mental status, change in gait, change in vision, decrease in sweating, muscle cramps, weakness, tremors, irregular heartbeat, chest pain, palpitations, hearing loss, difficulty in breathing, skin rash, cough, periorbital pain, worsening of condition, loss of control on seizure occur. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Carry identification card mentioning you have epilepsy and names of all…

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Interactions with Topiramate

Phenytoin, carbamazepine, digoxin, oral contraceptives, agents causing nephrolithiasis, hydrochlorothiazide, pioglitazone, metformin, lithium, risperidone, valproate, CNS depressants, alcohol, St John's wort, imipramine, moclobemide, proguanil, omeprazole, glibenclamide.

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Compiled by Healify Pharmacy from published drug references. How we compile it →

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