What is Topiramate?
Topiramate is one of the most widely used drugs in the group of antiepileptic drugs, which is used alone or in combination with other drugs to control seizures in adults and children.
Seizures are a nervous breakdown caused by a disturbance in the electrical activity of the brain. Topiramate helps control these attacks by reducing the abnormal electrical current in the brain cells.
Before taking topiramate
Inform your doctor if you are pregnant or trying to conceive or breastfeed.
Tell your doctor if you have a history of kidney, liver or drug allergies.
Because this drug can interfere with the function of other drugs in the body, it is necessary to provide a list of all your drugs before your doctor or pharmacist.
How to take topiramate
-Take the medicine exactly as your doctor advised. Taking this medicine varies depending on your condition and type of problem.
-Because this drug affects the nervous system, it should be taken regularly and under the supervision of a doctor. Although you may not feel better in the first few weeks of treatment, still continue your treatment and according to See your doctor regularly and also ask your doctor or pharmacist to improve the treatment of all your problems and issues.
-Discontinuation of this drug suddenly and without a doctor’s opinion can have adverse effects on the patient, including a seizure, so discontinuation of this drug should be done gradually and under the supervision of a physician.
– Your doctor may start treatment with a small amount of medication and after your body gets used to it, increase the amount of your medication to reduce the risk of side effects from the medication.
-The amount of medicine used in children is calculated by the doctor according to their condition, age and weight.
– This medicine does not interfere with food and can be taken before or after food. Topiramate tablets have a bitter taste, so swallow it whole with a glass of water and avoid chewing it.
– If you forget to take a dose, take it immediately after the reminder, unless the reminder time is close to the next dose. In this case, do not take the missed dose and take the next dose on time, but to Never double the dose.
Side effects of topiramate
Central nervous system: limb drowsiness, fatigue, drowsiness, memory impairment
Endocrinology and metabolism: reduction of serum bicarbonate, hyperammonemia, weight loss
Gastrointestinal: abdominal pain, anorexia, taste disturbance, nausea, diarrhea
Respiratory: Infection of the upper respiratory tract
Cardiovascular: hot flashes, chest pain
Central Nervous System: Attention Deficit Hyperactivity Disorder, Depression, Insomnia, Mood Disorder, Hypostasis, Anxiety, Cognitive Disorder, Psychomotor Disorder, Headache, Anger, Ataxia, Behavioral Problems, Confusion, Hypertension, Dizziness, Agitation, Aggravated Depression, Speech Disorder
Skin: Hair loss, itching, skin rash, acne vulgaris
Endocrinology and Metabolism: Menstrual Disorders, Intermenstrual Bleeding, Increased Gamma Glutamyl Transferase, Thirst
Gastrointestinal: indigestion, constipation, gastroenteritis, gastritis, dry mouth, reflux, lack of taste
Genitourinary: urinary tract infection, premature ejaculation, decreased libido, frequent urination, vaginal bleeding, bladder inflammation, urinary incontinence, urinary incontinence
Hematology and oncology: bleeding, anemia, tumor
Hypersensitivity: Hypersensitivity reactions
Infectious: viral infection, infection
Nervous, musculoskeletal: joint pain, laxity, muscle spasm, pain in the extremities
Ocular: Conjunctivitis, blurred vision, visual impairment
Ear: Middle ear infection
Kidney: Kidney stones
Respiratory: sinusitis, cough, rhinitis, pharyngitis, bronchitis, nosebleeds, shortness of breath
Miscellaneous: Unexpected injuries, speech and language disorders
Cardiovascular: hypotension, postural hypotension, syncope
Central nervous system: suicidal ideation, suicidal ideation
Endocrinology and metabolism: hyperchloremia, increased serum total protein, increased uric acid
Gastrointestinal: bleeding gums, hematuria
Hematology and oncology: Decreased serum phosphorus levels, decreased neutrophils, decreased white blood cells, increased eosinophil levels, increased platelets
Hepatic: Increased serum alkaline phosphatase
Nervous, muscular and skeletal: Muscular pain
Ocular: Myopia, scotoma (black spot in the field of view), visual field defect
Renal: Increased BUN, increased serum creatinine
Common side effects of topiramate
- Sleepiness, fatigue, dizziness and vision problems such as blurred vision are the side effects of this drug, so avoid driving and activities that require concentration and caution until the effect of the drug disappears.
- In case of mild diarrhea, it is recommended to drink enough fluids. Usually, the diarrhea caused by this medicine will go away on its own, but if this condition persists, see your
- If you feel nauseous from taking this drug, eating light and simple foods and avoiding high-fat and spicy foods will solve this problem.
- Be sure to see your doctor if you have symptoms of flu, sore throat, nasal problems, tingling in the fingers, and abnormal weight loss, severe mood swings, vision problems,
Uses of Topiramate
Topiramate is used as an adjunctive therapy in adults and children over 2 years of age in the treatment of partial seizures with or without secondary generalization, seizures with Lennox-Gastat syndrome, and primary generalized tonic-clonic seizures.
Due to the fact that this drug is made by several companies, the effect of the drug produced by different companies for the patient may be different, so how to use this drug is different depending on the manufacturer and brand name of the drug. For this reason, take the medicine exactly as your doctor advised, and also carefully read the medicine leaflet in the medicine box and ask your pharmacist your questions before using it.
It is best to refrain from changing your brand or drug company each time you receive your new prescription, and notify your doctor if necessary.
Because kidney stones are more likely to develop during treatment with this drug, it is necessary to use enough caffeinated water and fluids daily.
At the beginning of treatment with this drug, you may have more disturbing thoughts than before, but do not worry. You should know that these thoughts are caused by taking this drug and starting its effectiveness and will disappear over time.
In these cases, it is better to share your thoughts with your relatives or your counselor and doctor and take action to resolve them consciously.
Due to the side effects of this drug for the fetus, if you intend to become pregnant or suspect pregnancy, be sure to inform your doctor to change the drug and use the appropriate method to prevent pregnancy while taking this drug.
This drug reduces the effect of oral contraceptives, so if you are taking contraceptives, be sure to inform your doctor about taking this drug.
At the beginning of treatment for epilepsy epilepsy, the number or type of seizures may change slightly, but do not worry because this problem will resolve over time. Therefore, take the necessary precautions and contact your doctor.
Driving is not suitable for patients with epilepsy, but if seizures have not occurred within a year, you can start driving again with the advice of a doctor and with caution. However, if you drive, you should be aware of the timing of medications and the drowsiness caused by them.
Pharmacokinetics of topiramate
Absorption: fast and sufficient
One serum: fast release 4- 1 hour, continuous release 24 hours
Protein binding: fast release 13-17%, continuous release 15-41%
Metabolism: Hepatic (30%)
Half-life: 21 hours fast release, 31 hours continuous release
Excretion: Urine (80-70%)
Topiramate drug interactions
Alkaline compounds in urine
Category X Interactions (Avoidance)
Ethanol, azelastine (nose), bromoperidol, carbonic anhydrase inhibitors, orphenadrine, oxomazine, paraldehyde, thalidomide, olipristal
Reducing the effects of drugs by topiramate
Estrogen derivatives (contraceptives), methamphetamine, pioglitazone, primidone, progestins (contraceptives), olipristal
Reducing the effects of topiramate by drugs
Carbamazepine, Fos phenytoin, Mefloquine, Mianserin, Orlistat, Phenytoin
Increased effects of drugs by topiramate:
Alpha and beta agonists, amantadine, amitriptyline, amphetamines, azlastin (nasal), blonanserin, brexanolone, buprenorphine, carbonic anhydrase inhibitors, CNS suppressors, flacainide, flunitrazemine, lactosemine, fos phenytoin , Methotrimprazine, methyrosine, opioid agonists, orphanadrine, oxycodone, paraldehyde, phenytoin, piribidil, pramipexole, primidone, quinidine, ropinirole, rotigotine, SSRIs, surfactant, thalidomide, valproate products
Increased effects of topiramate by drugs:
Ethanol, Alizapride, Anticholinergic compounds, Brimonidine (topical), Bromoperide, Bromperidol, Cannabidiol, Cannabis, Chlormethiazole, Chlorphenzine Carbamate, Dimethidene (topical), Doxylamine, Dronabinol, Droperidol, Skantamine, Skidamine, Leidam Loops, magnesium sulfate, methotrexate, minocycline (systemic), nabilone, oxomazine, prampanel, rufinamide, salicylates, sodium oxibate, tetrahydrocannabinol, thiazide and thiazide diuretics, trimeprazine
A ketogenic diet may increase the risk of acidosis or kidney stones. Solution: The patient should be monitored for signs of acidosis or kidney stones.
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