Contents
The active substance in Topamax is topiramate. The drug has an antiepileptic effect, however, it is also used in the course of migraine therapy. Topamax, however, does not stop the seizure or migraine headache, but prevents them from happening. How does topiramate work, what are the contraindications to using this drug and potential side effects?
Topamax – action
The exact mechanism of action of Topamax is unknown. However, studies carried out on the culture of nerve cells show at least three features that determine or may determine its direction of action. The first property is blocking the so-called voltage-dependent sodium channels. The closure of these structures is associated with the inhibition of the inflow of sodium ions to the cell, which in turn leads to a situation in which the nerve cell is not excitable. The second mechanism of action of Topamax is the increase in the affinity of gamma-aminobutyric acid (GABA) to the receptor specific for this substance. A third feature of topiramate is its regulation of glutamatergic transmission. The listed properties of the drug prevent the appearance of seizures.
Topamax – indications
Topamax can be used as monotherapy in children over 6 years of age, adolescents and adults suffering from seizures:
- partial,
- secondary generalized tonic-clonic,
- originally generalized tonic-clonic.
However, topiramate is also used in combination with other medicines in children over 2 years of age, adolescents and adults with seizures:
- partial,
- secondary generalized tonic-clonic,
- primary generalized tonic-clonic,
- in the course of Lennox-Gastaut syndrome.
In addition to those mentioned, Topamax is also effective in migraine prophylaxis (preventing migraine attacks). Topiramate does not stop an acute headache or seizure, however!
Topamax – dosage
Dosing of antiepileptic drugs is done by gradually increasing the dose until effective is achieved. This is no different with Topamax. Taking the drug is started with the lowest dose, which is then increased as necessary. It is important not to divide the film-coated tablets, which are one of the forms of the preparation. Hard capsules are recommended, especially in children or the elderly, if you have difficulties swallowing the film-coated tablets. However, if this form of the drug is also difficult to swallow, you can open the capsule and mix the contents with a small amount of food (preferably soft, consumed on a dessert spoon or tea spoon). After mixing the contents of the capsule with food, eat everything immediately, do not chew it! It is also important not to prepare the previously described form of administration of the drug, but to do it just before taking it.
Topamax should be discontinued successively (over a period of about 2–8 weeks), gradually (usually weekly) reducing the dose taken. The use of Topamax must be under close medical supervision.
Topamax – contraindications to use
The main contraindication to the use of Topamax is hypersensitivity to the active substance (topiramate) or any of the excipients. Topiramate should not be used by women who are or are planning to become pregnant.
Topamax – warnings
When using Topamax, it should be borne in mind that the first doses of the drug may cause a new and different type of seizure. There may also be an increase in the frequency of attacks. This may be due to as many as four reasons, including: the so-called the paradoxical effect of the drug, disease progression, weakening of the effect of other drugs used concurrently with topiramate or simply too high initial dose of Topamax. In addition, while taking the drug, you should keep your body hydrated, as adequate fluid intake can prevent kidney stones.
Topamax – interactions
Topamax may interact with carbamazepine and phenytoin (potentiation of the effect of topiramate). Topiramate does not interact with other anticonvulsants, such as: valproic acid, phenobarbital, primidone. Topamax undergoes hepatic metabolism and therefore may interfere with the action of other drugs under the same process (e.g. omeprazole, imipramine, diazepam, proguanil, moclobemide). In addition, topiramate may interact with: digoxin, St. John’s wort, contraceptives, some diuretics, metformin. Alcohol should not be consumed during treatment with Topamax.
Topamax – side effects
The most frequently mentioned side effects when using Topamax are: appetite disorders, mental weakness, depression, drowsiness or insomnia, headaches and dizziness, memory dysfunction, double vision, nausea, diarrhea.
Producer leku: Janssen – Cilag International NV
Form, dose, package: hard capsules, (15; 25) mg, 60 pcs.; coated tablets, (25; 50; 100; 200) mg, 28 pcs.
Availability category: Rp – prescription drug
Active substance: topiramate
Before use, read the leaflet, which contains indications, contraindications, data on side effects and dosage as well as information on the use of the medicinal product, or consult your doctor or pharmacist, as each drug used improperly is a threat to your life or health. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.