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Generic Name
Topiramate
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| top 100 mg tablet | ৳ 6.02 | ৳ 60.17 |
Description
Overview of the medicine
Topiramate is an anticonvulsant and nerve pain medication used to treat epilepsy and prevent migraine headaches. It can also be used to treat Lennox-Gastaut syndrome. It is believed to work by affecting several different neurotransmitters in the brain.
Uses & Indications
Dosage
Adults
Epilepsy: Initially 25-50 mg/day, gradually increased to 200-400 mg/day in 2 divided doses. Migraine prophylaxis: Initially 25 mg/day, gradually increased to 50-100 mg/day in 2 divided doses.
Elderly
Initiate at lower doses and titrate gradually, similar to adults but with caution due to potential decreased renal function.
Renal_impairment
Reduce dose by 50% for CrCl < 70 mL/min.
How to Take
Oral administration. Tablets can be taken with or without food. Swallow whole, do not chew or crush. Ensure adequate fluid intake.
Mechanism of Action
Topiramate's exact mechanism is not fully understood, but it is believed to act through several mechanisms: blockade of voltage-dependent sodium channels, enhancement of GABAergic activity, antagonism of AMPA/kainate glutamate receptors, and inhibition of carbonic anhydrase enzyme.
Pharmacokinetics
Onset
Within a few days to weeks for therapeutic effect.
Excretion
Primarily excreted unchanged in the urine (approximately 70%).
Half life
Approximately 21 hours in adults.
Absorption
Well absorbed orally; peak plasma concentrations reached in 2-4 hours.
Metabolism
Minimally metabolized; 20-30% in healthy individuals, more in patients on enzyme-inducing antiepileptic drugs.
Side Effects
Contraindications
- Hypersensitivity to topiramate or any component of the formulation
- Acute porphyria
- Known allergy to sulfonamides (though cross-reactivity is rare)
Drug Interactions
Metformin
May require dose adjustment if taken concurrently.
Valproic Acid
Concurrent use has been associated with hyperammonemia with or without encephalopathy.
Oral Contraceptives
Topiramate may decrease the efficacy of oral contraceptives.
Phenytoin, Carbamazepine
May decrease topiramate plasma concentrations.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms include convulsions, drowsiness, speech disturbances, blurred vision, diplopia, lethargy, abdominal pain, agitation, depression, and metabolic acidosis. Treatment is supportive, including gastric lavage or activated charcoal if recent ingestion, and hydration.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm; risk-benefit must be carefully assessed. Avoid breastfeeding due to excretion in breast milk.
Side Effects
Contraindications
- Hypersensitivity to topiramate or any component of the formulation
- Acute porphyria
- Known allergy to sulfonamides (though cross-reactivity is rare)
Drug Interactions
Metformin
May require dose adjustment if taken concurrently.
Valproic Acid
Concurrent use has been associated with hyperammonemia with or without encephalopathy.
Oral Contraceptives
Topiramate may decrease the efficacy of oral contraceptives.
Phenytoin, Carbamazepine
May decrease topiramate plasma concentrations.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms include convulsions, drowsiness, speech disturbances, blurred vision, diplopia, lethargy, abdominal pain, agitation, depression, and metabolic acidosis. Treatment is supportive, including gastric lavage or activated charcoal if recent ingestion, and hydration.
Pregnancy & Lactation
Pregnancy Category D. May cause fetal harm; risk-benefit must be carefully assessed. Avoid breastfeeding due to excretion in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA and local regulatory bodies (e.g., DGDA)
Patent Status
Generic available, original patent expired
Clinical Trials
Numerous clinical trials have confirmed the efficacy and safety of topiramate in the treatment of epilepsy and migraine prophylaxis. Ongoing research explores its use in other neurological and psychiatric conditions.
Lab Monitoring
- Serum bicarbonate levels (for metabolic acidosis)
- Renal function tests
- Electrolytes
- Eye examinations periodically (for glaucoma)
Doctor Notes
- Counsel patients on adequate hydration to reduce renal stone risk.
- Monitor for signs of metabolic acidosis, especially in pediatric patients.
- Advise patients to report any vision changes promptly.
- Consider slow titration to minimize cognitive side effects.
Patient Guidelines
- Do not stop taking this medicine suddenly without consulting your doctor.
- Stay well-hydrated throughout the day.
- Report any visual disturbances or eye pain immediately.
- Be aware of potential dizziness and drowsiness, especially when starting treatment.
- Carry an identification card stating you are taking topiramate.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness, somnolence, and impaired concentration. Patients should be cautioned about driving or operating hazardous machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a balanced diet.
- Engage in regular, moderate exercise.
- Avoid excessive alcohol consumption.
- Manage stress effectively.
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International brand names for this medicine. Click a brand to search for detailed information.
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