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Indication & Dosage |
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| Oral |
| ADJUNCTIVE THERAPY FOR REFRACTORY PARTIAL SEIZURES, SEIZURES ASSOCIATED WITH THE LENNOX-GASTAUT SYNDROME AND PRIMARY GENERALISED TONIC-CLONIC SEIZURES |
| Adult:
16 yr: Initially, 25 mg nightly for 1 wk increased by 25-50-mg increments at 1-2 wk intervals until effective dose is reached. Daily doses >25 mg should be taken in 2 divided doses. Usual dose: 200-400 mg daily. |
| Max Dosage: 800 mg. |
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| Oral |
| ADJUNCTIVE THERAPY FOR REFRACTORY PARTIAL SEIZURES, SEIZURES ASSOCIATED WITH THE LENNOX-GASTAUT SYNDROME AND PRIMARY GENERALISED TONIC-CLONIC SEIZURES |
| Child:
2-16 yr: Initially, 25 mg nightly for the 1st wk increased at intervals of 1-2 wk by increments of 1-3 mg/kg daily according to response. Daily doses of >25 mg should be taken in 2 divided doses. Usual dose: 5-9 mg/kg daily. |
| Max Dosage: 30 mg/kg/day. |
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| Oral |
| MONOTHERAPY FOR PARTIAL SEIZURES AND PRIMARY AND SECONDARILY GENERALISED TONIC-CLONIC SEIZURES |
| Adult:
>16 yr: initially, 25 mg nightly for 1 wk increased by 25-50-mg increments at 1-2 wk intervals until effective dose is reached. Daily doses >25 mg should be taken in 2 divided doses. Initial target dose for newly diagnosed: 100 mg/day. |
| Max Dosage: 400 mg/day. |
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| Oral |
| MONOTHERAPY FOR PARTIAL SEIZURES AND PRIMARY AND SECONDARILY GENERALISED TONIC-CLONIC SEIZURES |
| Child:
10-16 yr: Initially, 0.5-1 mg/kg at night for the 1st wk, increased at intervals of 1-2 wk by increments of 0.5 to 1 mg/kg daily. Usual dose: 3-6 mg/kg daily. Daily doses >25 mg should be taken in 2 divided doses. |
| Max Dosage: 16 mg/kg/day. |
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| Oral |
| MIGRAINE PROPHYLAXIS |
| Adult:
>16 yr: Initially 25 mg daily, increased by 25-mg increments every wk. Usual dose: 100 mg daily. Daily doses >25 mg should be taken in 2 divided doses. |
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| Administration |
May be taken with or without food. |
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| Precautions |
Renal or hepatic impairment, pregnancy. May impair ability to drive or operate machinery. Maintain adequate hydration to reduce the risk of renal calculi especially in predisposed patients. Measure serum bicarbonate at baseline and periodically during treatment. Avoid abrupt withdrawal; decrease dose by 100 mg daily at wkly intervals. Seek immediate medical attention if blurred vision or eye pain. Monitor closely for decreased sweating and increased body temperature, especially in hot weather. Ensure proper hydration before and during activities or exposure to warm temperatures. |
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| Adverse Drug Reactions |
Confusion, dizziness, drowsiness, generalised slowing of mental and physical activity, difficulty with concentrations, ataxia, paresthesia, anorexia, weight loss, abnormal vision, metabolic acidosis, mood or mental changes, behavioural disturbances, depression, fatigue, agitation, nervousness, anxiety, oligohidrosis, hyperthermia and hyperammonaemic encephalopathy. |
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| Interactions |
Coadmin with antiepileptic drugs e.g. phenytoin, carbamazepine, phenobarbital decreases plasma concentration of topiramate. Possible increase in phenytoin levels. Increased risk of renal stone formation with carbonic anhydrase inhibitors e.g. acetazolamide. Increased risk of CNS depression with CNS depressants and alcohol. Increased risk of hyperammonaemia and encephalopathy with valproic acid. Increased risk of contraceptive failure in women taking combined oral contraceptives. |
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