Topirva-XR
Generic Name
Topiramate Extended-Release
Manufacturer
Hypothetical Manufacturer
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| topirva xr 50 mg capsule | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Topiramate extended-release is an anticonvulsant medication used to treat epilepsy and prevent migraine headaches. It works by affecting several chemicals in the brain.
Uses & Indications
Dosage
Adults
For epilepsy: Initial 25 mg once daily at night for 1 week, then titrate weekly by 25-50 mg/day to a target dose of 100-200 mg/day. For migraine prophylaxis: Initial 25 mg once daily at night for 1 week, then increase to 50 mg once daily.
Elderly
Cautious dosing, generally starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Monitor renal function.
Renal_impairment
Dosage reduction (e.g., 50% of usual dose) and/or extended dosing interval may be required for patients with creatinine clearance <70 mL/min/1.73 m².
How to Take
Take orally, once daily. Swallow the capsule whole; do not chew, crush, or open. Can be taken with or without food. Ensure adequate hydration.
Mechanism of Action
Topiramate has multiple mechanisms of action, including blocking voltage-dependent sodium channels, enhancing GABA-A receptor activity, antagonizing AMPA/kainate glutamate receptors, and inhibiting carbonic anhydrase.
Pharmacokinetics
Onset
Onset of antiepileptic effect may take several days to weeks; migraine prophylaxis effect also takes time to build up.
Excretion
Primarily renal excretion (approximately 70% as unchanged drug).
Half life
Approximately 21 hours (for immediate-release). Extended-release may show longer effective half-life.
Absorption
Well absorbed orally, bioavailability is approximately 80% (for immediate-release). Extended-release formulation provides sustained plasma concentrations.
Metabolism
Minimally metabolized; primarily unchanged drug excreted by the kidneys (approximately 70%).
Side Effects
Contraindications
- Hypersensitivity to topiramate or any component of the formulation.
- Patients with a history of metabolic acidosis while on metformin (for certain indications).
Drug Interactions
Metformin
May increase the risk of metabolic acidosis when used with Topiramate.
Valproic Acid
Concomitant use may increase the risk of hyperammonemia with or without encephalopathy.
Oral Contraceptives
May decrease the contraceptive efficacy of estrogen-containing oral contraceptives.
Phenytoin, Carbamazepine
May alter topiramate plasma concentrations. Dosage adjustment may be needed.
CNS Depressants (e.g., alcohol, benzodiazepines)
May enhance CNS depression.
Storage
Store at room temperature (20°C to 25°C), excursions permitted to 15°C to 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include convulsions, severe drowsiness, speech disturbance, blurred vision, diplopia, lethargy, ataxia, abdominal pain, agitation, depression, metabolic acidosis, and coma. Treatment is supportive; hemodialysis can be an effective means of removing topiramate from the body.
Pregnancy & Lactation
Pregnancy Category D. Topiramate can cause fetal harm. Not recommended during breastfeeding as it is excreted in breast milk and may cause adverse effects in a breastfed infant.
Side Effects
Contraindications
- Hypersensitivity to topiramate or any component of the formulation.
- Patients with a history of metabolic acidosis while on metformin (for certain indications).
Drug Interactions
Metformin
May increase the risk of metabolic acidosis when used with Topiramate.
Valproic Acid
Concomitant use may increase the risk of hyperammonemia with or without encephalopathy.
Oral Contraceptives
May decrease the contraceptive efficacy of estrogen-containing oral contraceptives.
Phenytoin, Carbamazepine
May alter topiramate plasma concentrations. Dosage adjustment may be needed.
CNS Depressants (e.g., alcohol, benzodiazepines)
May enhance CNS depression.
Storage
Store at room temperature (20°C to 25°C), excursions permitted to 15°C to 30°C. Protect from moisture and light. Keep out of reach of children.
Overdose
Symptoms of overdose include convulsions, severe drowsiness, speech disturbance, blurred vision, diplopia, lethargy, ataxia, abdominal pain, agitation, depression, metabolic acidosis, and coma. Treatment is supportive; hemodialysis can be an effective means of removing topiramate from the body.
Pregnancy & Lactation
Pregnancy Category D. Topiramate can cause fetal harm. Not recommended during breastfeeding as it is excreted in breast milk and may cause adverse effects in a breastfed infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture, refer to the package for exact date.
Availability
Pharmacies, hospitals
Approval Status
FDA approved (for active ingredient)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Topiramate has undergone extensive clinical trials demonstrating its efficacy and safety for the treatment of epilepsy and migraine prophylaxis in various patient populations.
Lab Monitoring
- Serum bicarbonate levels (due to risk of metabolic acidosis)
- Renal function (creatinine clearance)
- Electrolyte levels
- Intraocular pressure (if visual symptoms occur)
Doctor Notes
- Counsel patients on potential cognitive side effects, especially during initial titration.
- Emphasize the importance of adequate hydration to mitigate kidney stone risk.
- Monitor serum bicarbonate levels, especially in patients at risk for metabolic acidosis.
Patient Guidelines
- Do not stop taking Topiramate suddenly, as this may increase seizure frequency.
- Drink plenty of fluids throughout the day to help prevent kidney stone formation.
- Report any changes in vision, mood, or unusual sensations to your doctor immediately.
- Avoid activities requiring mental alertness until you know how Topiramate affects you.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Topiramate may cause dizziness, somnolence, visual disturbances, and impaired coordination. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Topiramate therapy does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain a balanced diet and stay well-hydrated.
- Avoid alcohol, as it may enhance CNS side effects like dizziness and drowsiness.
- Regular exercise may help manage weight and overall well-being.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
Other Medicines in Topirva-XR Brand
Other medicines available under the same brand name
