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Generic Name
Topiramate
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| top 50 mg tablet | ৳ 3.51 | ৳ 35.08 |
Description
Overview of the medicine
Topiramate is an antiepileptic drug used to treat epilepsy and prevent migraine headaches.
Uses & Indications
Dosage
Adults
Epilepsy: Initial 25-50 mg/day, titrated to 100-400 mg/day in 2 divided doses. Migraine prophylaxis: Initial 25 mg at night, titrated to 100 mg/day in 2 divided doses.
Elderly
Use with caution, monitor renal function.
Renal_impairment
Dosage adjustment required, typically reduced by 50%.
How to Take
Take orally, with or without food. Swallow whole, do not chew or crush.
Mechanism of Action
Multiple mechanisms including blockage of voltage-dependent sodium channels, enhancement of GABAergic activity, antagonism of AMPA/kainate receptors, and inhibition of carbonic anhydrase.
Pharmacokinetics
Onset
Varies by indication, generally gradual.
Excretion
Primarily excreted unchanged in urine.
Half life
Approximately 21 hours.
Absorption
Rapidly and well absorbed, ~80% bioavailability.
Metabolism
Minimally metabolized, primarily renal excretion.
Side Effects
Contraindications
- Hypersensitivity to Topiramate or any component of the formulation.
Drug Interactions
Oral Contraceptives
May decrease efficacy of oral contraceptives.
CNS Depressants (e.g., alcohol, benzodiazepines)
Additive CNS depression.
Carbonic Anhydrase Inhibitors (e.g., Acetazolamide)
Increased risk of kidney stones and metabolic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture.
Overdose
Symptoms include convulsions, drowsiness, speech disturbance, blurred vision, hypotension, abdominal pain. Management is supportive, including gastric lavage or activated charcoal if recent.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Not recommended during breastfeeding due to excretion in milk.
Side Effects
Contraindications
- Hypersensitivity to Topiramate or any component of the formulation.
Drug Interactions
Oral Contraceptives
May decrease efficacy of oral contraceptives.
CNS Depressants (e.g., alcohol, benzodiazepines)
Additive CNS depression.
Carbonic Anhydrase Inhibitors (e.g., Acetazolamide)
Increased risk of kidney stones and metabolic acidosis.
Storage
Store below 30°C in a dry place, away from light and moisture.
Overdose
Symptoms include convulsions, drowsiness, speech disturbance, blurred vision, hypotension, abdominal pain. Management is supportive, including gastric lavage or activated charcoal if recent.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm. Not recommended during breastfeeding due to excretion in milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
Clinical Trials
Extensively studied in numerous clinical trials for epilepsy and migraine prophylaxis.
Lab Monitoring
- Regular monitoring of serum bicarbonate, electrolytes, and renal function is recommended.
Doctor Notes
- Counsel patients on adequate hydration and slow titration to minimize side effects.
- Monitor for mood changes and suicidal ideation, especially at the start of treatment or dose changes.
Patient Guidelines
- Do not stop abruptly, as this may increase seizure frequency.
- Drink plenty of fluids to reduce the risk of kidney stones.
- Be aware of potential cognitive side effects.
Missed Dose Advice
Take as soon as remembered unless it's almost time for the next dose. Do not double dose.
Driving Precautions
May cause dizziness, drowsiness, or visual disturbances. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain adequate hydration.
- Avoid alcohol as it may worsen CNS side effects.
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