topiramate

TOPIRAMATE

Manufacturer: Bryant Ranch Prepack

Score: 145.0

Quick Summary

Topiramate is an antiepileptic drug used for the treatment of partial onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome. It is available in various dosages, including 25 mg, 50 mg, 100 mg, and 200 mg tablets. The initial dose for adults and pediatric patients 10 years and older is 50 mg/day, which can be increased by 50 mg/day each week. For pediatric patients 2 to 9 years of age, the initial dose is 25 mg/day, which can be increased by 25 mg/day each week. The maximum recommended dose is 400 mg/day in two divided doses. Topiramate can cause serious side effects, including suicidal thoughts and behaviors, and should be used with caution in patients with a history of depression or mood disorders. It is also important to monitor patients for signs of metabolic acidosis, kidney stones, and increased intraocular pressure.

Key Clinical Findings and Indications

Treatment of partial onset seizures
Treatment of primary generalized tonic-clonic seizures
Treatment of seizures associated with Lennox-Gastaut syndrome
Monotherapy or adjunctive therapy

Important Safety Information

Warning

Topiramate can cause suicidal thoughts and behaviors, and patients should be monitored closely for signs of depression or mood disorders.

Contraindications

None

Adverse Reactions

Paresthesia
Anorexia
Weight decrease
Somnolence
Dizziness
Nervousness
Psychomotor slowing
Abnormal vision
Fever

Dosing Recommendations

General Guidance

Dose adjustments may be necessary for patients with renal impairment or hepatic impairment.

Partial onset seizures

Adult Dose

50 mg/day, increased by 50 mg/day each week

Pediatric Dose

25 mg/day, increased by 25 mg/day each week

Primary generalized tonic-clonic seizures

Adult Dose

50 mg/day, increased by 50 mg/day each week

Pediatric Dose

25 mg/day, increased by 25 mg/day each week

Special Population Considerations

Pregnancy

Topiramate can cause fetal harm and should be used during pregnancy only if the potential benefit outweighs the potential risk.
Patients should be monitored for metabolic acidosis and treated as in the nonpregnant state.

Nursing Mothers

Topiramate is excreted in breast milk and should be used with caution in nursing mothers.
Caution should be exercised when administering topiramate to a nursing woman.

Pediatric Use

Safety and effectiveness in patients below the age of 2 years have not been established for the adjunctive therapy treatment of partial onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome.
Topiramate has been associated with growth/length retardation, certain clinical laboratory abnormalities, and other adverse reactions/toxicities in pediatric patients.

Geriatric Use

Dosage adjustment may be necessary for elderly patients with impaired renal function.
Topiramate has not been studied in patients over 65 years of age, and the effects of topiramate on the elderly are not well understood.

Similar Drugs

Tiagabine Hydrochloride

TIAGABINE HYDROCHLORIDE

Teva Pharmaceuticals USA, Inc.

Similarity: 60.7%