Meds and you

27 September 2013

Topiramate

Topiramate is an anticonvulsant. Anticonvulsants are drugs that are used to treat or prevent convulsions, i.e. the seizures seen in epilepsy.

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Topiramate is the active ingredient of Topamax (Nappi Code: 822515-008, 822523-019, 822531-003, 836753-003 & 878014-004) and Toplep (Nappi Code: 708389-001, 708390-001, 708391-001 & 708392-001).

General information
Topiramate is an anticonvulsant. Anticonvulsants are drugs that are used to treat or prevent convulsions, i.e. the seizures seen in epilepsy.

Topiramate can be used on its own as monotherapy, but is often used as an adjunctive treatment for epilepsy not controlled by conventional drugs.

In South Africa topiramate is registered for the treatment of partial seizures, a seizure that starts in one particular part of the brain, and primary generalised seizures, seizures which occur when electrical discharges begin in both halves of the brain at the same time.

It is furthermore applied for the treatment of Lennox-Gastaux syndrome, a difficult-to-treat form of childhood-onset epilepsy.

When taking this drug as long-term therapy, it is advised that you should drink plenty of water, especially when exercising or in warm weather.

Do not stop using this antiepileptic drug abruptly as it may cause seizures. It is advised that you decrease your dose gradually, and only as directed by your doctor.

Because topiramate may cause dizziness, light-headedness and/or sedation, driving and any hazardous tasks should be avoided until you know how this medication affects you.

How does topiramate work?
Topiramate stabilises electrical activity in the brain and therefore reduces the risk seizures.

Fast facts

Drug schedule: schedule 3
Available as: topiramate is available as tablets and capsules.
What does it do? Reduces the risk of seizures.
Overdose risk: medium
Dependence risk: low
Is Topiramate available as a generic? yes
Is Topiramate available on prescription only? yes

User information

Onset of effect: the full effect of this drug is only seen after a few days of treatment.
Duration of action: up to 25 hours
Dietary advice: when taking this drug as long-term therapy, it is advised that you should drink plenty of water, especially when exercising or in warm weather.
Stopping this medicine: do not stop using this antiepileptic drug abruptly as it may cause seizures. It is advised that you decrease your dose gradually, and only as directed by your doctor.

Special precautions
Consult your doctor before using this drug if:

 

  • you have liver or kidney disease
  • you are pregnant or plan to fall pregnant
  • you have a risk of developing kidney stones
  • you are taking other drugs

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 4 years.
The elderly: caution is advised in the elderly as side-effects may occur more frequently.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
sedation
X
 
X
 
loss of coordination
 
X
 
X
impaired concentration
 
X
X
 
confusion
 
X
 
X
dizziness
 
X
X
 
fatigue
 
X
X
 
abnormal thoughts
 
X
X
 
agitation
 
X
X
 
loss of appetite
 
X
X
 
nausea
 
X
X
 
speech disorder
 
X
 
X
altered taste
 
X
X
 
swollen gums
 
X
 
X
skin rash
 
X
 
X
visual disturbance/eye pain
 
X
 
X
double vision
 
X
 
X

Interactions

 

alcohol increased sedation
carbamazepine reduced effect of topiramate
digoxin reduced effect of digoxin
oral contraceptives risk of pill failure
phenytoin risk of phenytoin toxicity

Disease interactions
Consult your doctor before using this drug if you have liver or kidney disease or if you have a tendency to develop kidney stones.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults: oral, 200-800 mg/day

 

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.
 
 

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