Medication

Topamax

Structure

1 capsule of Topamax contains 50, 25 or 15 mg topiramata.

Additional substances: sugar grains (sucrose, starch syrup), povidone, cellulose acetate.

The composition of the capsule shell: water, gelatin, sorbitan laurate, sodium lauryl sulfate, titanium dioxide, Opacode Black ink black (black aboutiron oxideglaze solution in ethyl alcohol, isopropyl alcohol, butyl alcohol, propylene glycol, ammonium hydroxide).

Release form

Topamax is a hard gelatin white capsule with the inscription “50 mg” in black ink and a colorless cap with the inscription “TOP” in black ink; the inner contents of the capsules are white granules.

Pharmachologic effect

Anticonvulsant.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Antiepileptic drug, refers to the group of derivatives of fructose.

Topiramat inhibits sodium channels and inhibits the appearance of repeated action potentials during prolonged depolarization of the neuron wall. Increases activity gamma-aminobutyric acid regarding a number of subtypes GABA receptors and regulates activity GABAA Receptorsblocks activation kainatom receptors for glutamate. These Topamax effects are dose-dependent in the concentration range. topiramata in the blood 1-200 μmol.

Topiramate inhibits the activity of certain isomers carbonic anhydrase. However, in terms of the severity of this pharmacological effect, it is much inferior acetazolamide - inhibitor carbonic anhydrase. This activity of the drug is not its main component antiepileptic activity.

Pharmacokinetics

After taking topiramate quickly absorbed from the intestines. Bioavailability reaches 81%. Eating does not affect the bioavailability of the drug. Binding to plasma proteins - 13-17%.

In individuals with healthy kidney function, it will take 4-8 days to reach an equilibrium state. Transformation undergoes up to 20% of the dose taken. 6 inactive metabolites are known. Topiramate and its derivatives are excreted by the kidneys. The elimination half-life averages 21 hours.

Indications for use

  • Migraine:
    - prevention migraine.
  • Epilepsy:
    - as monotherapy in children from 2 years old and adults suffering from epilepsy and in people with newly diagnosed epilepsy;
    - as a component of complex therapy in children from 2 years old and adults with generalized or partial tonic-clonic seizures; for the treatment of seizures with Lennox-Gastaut syndrome.

Contraindications

  • Age to two years.
  • Hypersensitivity to the components of the drug.
  • With caution, Topamax should be used with nephrourolithiasis, hepatic or renal failure, hypercalciuria.

Side effects

  • Violations of the nervous system: paresthesia, drowsiness, dizzinessapathy nystagmusviolation of thinking, speech, memory and concentration, lethargy, tremor, amnesia, a change in taste, cognitive impairment, psychomotor disturbances, loss of a sense of taste and smell, akinesia, apraxia, aphasia, cerebellar syndromeburning sensation, sleep rhythm disturbance, impaired coordination, crampsincreased salivation dysgraphia, dysesthesia, dyskinesia, dystonia, dysphasia, tonic-clonic seizures, hyperesthesia, hypokinesia, hypogevzia, hyposmia, parosmiarepeated speech stupor, violation of touch, fainting.
  • Mental disorders: confusion, slow thinking, depressionaggressive reactions insomniaexcitement emotional lability, disorientation, anorgasmia, crysexual dysfunction dyspemiaeuphoric mood hallucinationsdecrease libido, hypomanic states, mania, paranoid conditions, panic state, perseveration of thinking, restlessnesssuicidal ideas tearfulness.
  • Digestive system disorders: anorexiaappetite change diarrhea, constipationabdominal pain, dry mouth, pancreatitischanges in sensitivity in the mouth, gastroesophageal reflux, gastritisbleeding gums flatulencethirst glossodynia, dyspeptic symptoms.
  • Musculoskeletal disorders: myalgia, cramps, muscle pain, cramps, arthralgiastiff muscles, swelling of the joints.
  • Disorders of the cardiovascular system: orthostatic hypotension, bradycardia, tachycardia, Raynaud's syndrome.
  • Vision disorders: visual impairment, diplopiadry eyes, disturbance of accommodation, blepharospasm, amblyopia,one-sided blindness, mydriasis, photopsynight blindness presbyopiadecreased visual acuity, angle-closure glaucomaswelling of the eyelids, conjunctival edema, myopia, maculopathy.
  • Hearing damage: pain and tinnitus, deafnesshearing impairment.
  • Respiratory system disorders: nosebleeds, hoarseness, dyspnea, nasal congestion, rhinorrhea, nasopharyngitis.
  • Skin lesions: rash, itching, alopecialack of sweating, redness of the skin, allergic dermatitisviolation of skin pigmentation, unpleasant odor, hives, erythema multiforme, paraorbital edema.
  • Urinary system lesions: pollakiuria, hematuria, nephrolithiasis, urolithiasis, renal colic, dysuria urinary incontinence, kidney pain, renal tubular acidosis.
  • Hematopoietic system lesions: anemia, leukopenia, thrombocytopenia, lymphadenopathy, eosinophilia, neutropenia.
  • Changes in laboratory parameters: a decrease in the concentration of bicarbonates in the blood, leukopenia, crystalluria, hypokalemia.
  • General disorders: fatigue, decrease or increase in body weight, anxiety, heatswelling of the face hyperchloremicor metabolic acidosis, allergic reactionslimb cooling weaknessfatigue calcificationflu-like diseases generalized edema.

Instructions for use Topamax (Method and dosage)

According to the instructions for Topamax, the drug is taken orally, regardless of the meal. The capsule must be opened, mix its contents with a small amount of soft food. Then swallow quickly without chewing. Also, capsules are allowed to be swallowed whole.

For better control of epileptic seizures in patients of all ages, it is recommended to start therapy with taking the drug in low doses, then titrate to an effective dose.

Tonic-clonic seizures (partial, generalized), seizures with Lennox-Gastaut syndrome. The smallest effective dose in adults is 200 mg per day. The daily dose ranges from 200 mg to 400 mg and is used in two divided doses. The use of the maximum daily dose of 1600 mg may be indicated for some patients. The dose is selected from 25-50 mg at night, once a day for a week. Then the dose can be increased by 25-50 mg and divided into 2 doses. In a number of patients, the effect is achieved when taken once a day.

In children, the recommended total daily dose as a component of polytherapy is 5-9 mg per kilogram of weight and is divided into two doses.

Epilepsy. In adults, with monotherapy at the beginning, 25 mg of Topamax is prescribed once a day for a week. Subsequently, the dose is increased with an interval of 7-14 days by 25-50 mg. If necessary, it is possible to make longer intervals between dose increases, or increase the dose in smaller increments. The initial dose for adult epilepsy is 100 mg per day, and the maximum daily dose is 500 mg.

The recommended dose for monotherapy of epilepsy in children can range from 100-400 mg per day.

Migraine. For the prevention of migraine, the daily dose should be 50 mg twice a day. If necessary, you can practice increasing the dose before the onset of the clinical effect.

Overdose

Symptoms drowsiness, cramps, impaired function of speech and vision, impaired thinking and coordination, diplopia, lethargy, arterial hypotension, dizziness, depression. Perhaps development metabolic acidosis severe degree.

Treatment: gastric lavage or inducing vomiting; the reception activated carbonwhich effectively adsorbs topiramate; symptomatic therapy hemodialysisincrease in fluid intake.

Interaction

Phenytoin and carbamazepine lower the content of Topamax in plasma.

Topamax may decrease concentration digoxin in blood.

The effects caused by the joint use of drugs that cause depression of nerve functions, of alcohol and Topamax have not been studied.

Joint reception Hypericum perforatum lowers concentration topiramatain blood.

When using high doses topiramata (less than 600 mg / day) and lithium preparations, the concentration of the latter may increase.

When used together topiramata and hydrochlorothiazide there is an increase in concentration topiramata in blood.

With the appointment of patients Glibenclamide and Topiramata their condition should be monitored to assess the nature of the course diabetes mellitus.

The simultaneous use of Topamax with drugs predisposing to development nephrolithiasismay further increase the risk of kidney stone production. Such combinations should be avoided.

Combined use valproic acid and topiramata often accompanied hyperammonemia in some cases with development encephalopathy.

Terms of sale

Topamax is on the list of prescription drugs.

Storage conditions

Store at temperatures up to 26 degrees. Keep out of the reach of children.

Shelf life

Two years.

Special instructions

Topamax should be discontinued slowly over a period of 2-8 weeks in order to negate the possibility of increasing the frequency of seizures.
During treatment with the drug, an increased incidence of mood disorders, suicidal thoughts, depression and suicidal behavior is observed.

If the patient loses weight during therapy with Topamax, it is advisable to consider switching to enhanced nutrition.

Topamax can cause dizziness, blurred vision, drowsiness, and a number of other symptoms that pose a serious danger to people driving a car.

Analogs

Matches for ATX Level 4 code:GabagammaNeurontinPaglüferalAlgericaTopiramatConvalisLamotrigineLamictalGabapentinKeppraPregabalin RichterTebantin

Analogs of Topamax: Topilex, Topiramin, Toprakar, Epiramat, Epiramat-Teva.

For children

Children under two years of age are prohibited.

With alcohol

It is not recommended to drink alcohol-containing drinks during the period of therapy with the drug.

In pregnancy (and lactation)

During the period of pregnancy or lactation it is necessary to interrupt Topamax treatment.

Topamax reviews

Reviews of Topamax indicate poor tolerability of the drug by patients of all ages and a high incidence of side effects, especially from the nervous system and psyche. The drug is actively used as a means for losing weight in many countries, however, when using Topamax for these purposes, its high toxicity should be taken into account.

Topamax price, where to buy

In the Russian Federation, the price of Topamax 50 mg is 1426-1641 rubles, and the price of Topamax 25 mg is 2046-2506 rubles. You can buy Topamax with a dosage of 50 and 25 mg in Ukraine for 421 and 287 rubles, respectively.

  • Online Pharmacies in Russia
  • Online pharmacies in UkraineUkraine
  • Online pharmacies in Kazakhstan

LuxPharma * special offer

  • Topamax tablets 25mg 60pcs
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ZdravCity

  • Topamax capsule 25mg No. 60 Janssen-Orto LLS / Janssen-Silag S.p.A. 755 rub.order

Pharmacy Dialog

  • Topamax (caps. 25mg No. 60) 779 rub.order
  • Topamax (caps. 25mg No. 60) 785 rub.order
  • Topamax (caps. 50mg No. 60) 1207 rub.order
  • Topamax (caps. 50mg No. 60) 1053 rub.order

Eurofarm * 4% discount on the promotional code medside11

  • Topamax 25 mg No. 60 capsules Janssen-Ortho / Janssen-Cilag846 rub.
  • Topamax 50 mg No. 60 capsules Janssen-Ortho / Janssen-Cilag 1334 rub.
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Pharmacy24

  • Topamax 50 mg N28 capsules Janssen-Silag S.p.A., Italy / Janssen Ortho LLS, USA459 UAH.order
  • Topamax 25 mg No. 28 capsules Janssen-Silag S.p.A., Italy / Janssen Ortho LLS, USA303 UAH.order

Pani Pharmacy

  • Topamax capsule Topamax caps. 25mg No. 28 Italy, Janssen-Cilag 306 UAH order
  • Topamax capsule Topamax caps. 50mg No. 28 Italy, Janssen-Cilag 472 UAH to order
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BIOSPHERE

  • Topamax 25 mg No. 60 caps. Janssen-Ortho LLS (Puerto Rico) 19 tg.
  • Topamax 50 mg No. 60 caps. Janssen-Ortho LLS (Puerto Rico) 38 tg.
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