General Info: Uses and Effects

This medicine is used for treating indications like seizures (epilepsy) and headaches from migraines. However once the migraine headache has already begun the drug will not be useful. The medication used alone or used along with other kinds of drugs. If the patient has a migraine the treatment has to done under the supervision of a doctor. The drug is also referred to as anticonvulsant or antiepileptic drug. Epilepsy is a form of disorder relating to the brains electrical systems that have a tendency to produce repeated seizures which may occur in children or adults.

Contraindication: Important to Know

There are several conditions in a patient which are not suited for consuming Topamax. The conditions may related to chronic kidney disease varying from moderate to severe stages, arginase deficiency, hyperammonemia, ornithine carbamoyltransferase deficiency, citrullimenia, numbness and tingling sensation, Deficiency of Carbamyl Phosphate Synthetase that is inherited, Deficiency of Arginosuccinate Lyase that is inherited, secondary closure glaucoma, during periods of pregnancy, fever, diarrhea, memory loss, difficulty in focusing, less sweating, stones in kidney, liver health issues, poor sharpness in vision, enhanced pressure in eye, depression, suicidal thoughts, confusion, excessive body acid. The patient needs to be hydrated and there has to be sufficient caloric consumption. Ketogenic diets should not be taken. The patient needs to disclose to the doctor or pharmacist if he/she is allergic to the drug as it may contain inactive elements. The medical history of the patient also needs to be informed to the doctor or pharmacist to avoid severe life threatening side effects. Alcohol should be avoided and during hot climate the patient needs to avoid excessive physical workouts. The patient should try to keep cool body temperatures and is advised to seek medical help in case of fever, headaches or mood swings. The drug may cause weak bones, less sweating as well as decreased growth in children who are more susceptible. Patients who are old may be prone to dizziness which may cause falling and in pregnant patients it should strictly be considered under medical supervision which can cause detrimental effects on an unborn child. The patient also needs to inform the doctor if planning to become pregnant, it has to be noted that if the patient is using it for treating seizures, untreated seizures may cause serious issues during pregnancy. Metformin (Glucophage) is also contraindicated for individuals who have metabolic acidosis.

Instructions on taking

The drug should be used as per the directions of the doctor and all information needs to be understood before consumption. It may be taken with or without any food. It should be swallowed in whole and should not be chewed inside the mouth. To get the most benefits the doses should not skipped. Even if the patient feels better it is suggested to continue taking the drug as prescribed by the doctor. The intake of the drug should not be stopped abruptly which may increase the chances of having seizures, it should be done in a gradual manner as advised by the doctor. The patient needs to remain well hydrated by consuming non-caffeine beverages unless the doctor suggests drinking in lesser quantity. The patient should have a blood test done, especially when he/she is also consuming lithium.

Dosage

The dosage is indicated as per the age of the patient, the strength of the drug and indication sought to be taken for.

For the normal dosage in adults having epilepsy having monotherapy the immediate release tablets is 400mg per day which is divided in two dosages on weekly basis for around six weeks. When consuming the extended release tablets the dosage is 400mg per day taken for six weeks increased as the weeks progress, with 50mg in first week, 100mg in second week,150mg in third week, 200mg in fourth week, 300mg in fifth week, 400mg in sixth week. In adjunctive therapy the immediate release tablets is taken 200mg to 400 mg per day divided into two for partial seizures, 400mg per day divided into two doses for primary generalized tonic-clonic seizures where the initial treatment begins at 25mg to 50 mg once in the day followed by an increase of 25mg to 50mg weekly.

For treating migraine prophylaxis in adults the normal dosage when consuming the immediate release tablets is 25mg only at or after 12PM in the first week, 25mg in before 12PM and 25mg on or after 12PM in the second week, 25mg before 12PM and 50mg after 12PM in the third week, 50mg before 12PM and 50mg on or after 12PM in the fourth week. When consuming the extended release tablets the dosage is 100mg one time in the day, 25mg one time during the day in the first week, 50mg one time during day in the second week, 75 mg one time during the day in the third week, 100mg one time in the day in the fourth week.

For treating lennox-gastaut syndrome in adults the dosage is 200mg to 400mg everyday divided in two dosages for the immediate release tablets with 25mg to 50mg everyday increasing by 25mg to 50mg daily on a weekly basis. For extended release tablets the dosage is 200mg to 400mg everyday followed by the same dosage and increments as above.

Side Effects

There are numerous side effects associated with the drug and to avoid it all medical history and information relating to the usage of drugs should be provided to the doctor or pharmacist. The common ones include nervousness, dizziness, menstrual and vision problems, weak concentration etc. with other side effects being like arthralgia as well as asthenia.

Interaction with Other Drugs

There are numerous drugs which interact with Topamax such as dorzolamide (Trusopt), acetazolamide (Diamox), methazolamide (Neptazane), dichlorphenamide (Daranide).

Drugs like phenytoin (Dilantin) or Carbamazepine (Tegretol) caused significant reduction of the drug which eliminates it from the body also reducing effectiveness unless dosage is enhanced.

The drugs relating to valproic acid enhances blood ammonia levels which may result in hypothermia.

The drug may also lessen estrogen in women who are consuming oral contraceptives, subsequently enhancing unnecessary pregnancy as well as bleeding.

Anticonvulsant medications also react in patients taking the medication for seizures, the drug may also produce metabolic acidosis.

It may increase lithium (Eskalith, Lithobid) when consuming increased doses.