Seizures may be classified as partial if they involve only a small part of the brain or generalized if they involve a greater part of the brain. Topamax is used in combination with other medications for adults and children aged 2-16 years with partial seizures or generalized tonic-clonic seizures (in which there is prolonged contraction of the muscles of the body which causes twitching of the body).
Topamax capsules are approved for treatment without other drugs in patients aged 10 years or older.
Topamax is also used in patients of two years old and older with seizures associated with Lennox-Gastaut syndrome, a severe form of epilepsy which accounts for 10 percent of all cases of childhood epilepsy. Children with Lennox-Gastaut have mental delays and to dozens of different, mixed types of seizures every day. The most common symptoms of this syndrome are seizure dilated pupils and shallow, irregular breathing, seizures may be atonic (brief loss of muscle tone and consciousness, causing abrupt falls) and myoclonic (sudden jerking muscles).
Mode of application
Most often, Topamax is taken in small doses, 25 or 50 mg per day, and the dose may increase gradually as directed by the doctor, from 25 to 50 mg per week until an effective daily dose is reached. This slow approach to treatment reduces side effects. In children, the initial dose is 25 mg (1 to 3 mg / kg / day), taken at night during the first week. Then the dose is increased by 1 or 2, at weekly intervals from 1 to 3 mg / kg / day. Although the usual adult dose is 200 mg twice daily, some adult patients may feel the effectiveness of the drug at 200 mg per day. Some patients need doses higher than 200 mg per day. In children the usual dose is 2.5 to 4.5 mg / kg twice a day. Patients should maintain adequate fluid intake in order to minimize the risk of kidney stones.
Mechanism of action
Topamax is an oral drug that is used to prevent seizures of epilepsy. It is used primarily in patients who are not under the control of other antiepileptic drugs. Approximately 1 in 4 Americans diagnosed with epilepsy and resistant to treatment with other antiepileptic drugs are taking this medicine. Topamax also prevents migraine. Convulsions associated with abnormal activity ("firing") nerves in the brain extends to larger or smaller parts of the brain. Although the exact mechanism of action of Topamax is unknown, research shows that this can change the neurotransmitters in the brain. Neurotransmitters are chemicals that nerves manufacture and use to communicate with other nearby nerves. Altering the production or action of neurotransmitters, Topamax can suppress the abnormal activity of the nerves in the brain that cause seizures or may prevent the abnormal activity that spreads to other nerves. Other studies suggest that Topamax may suppress the nerves directly (without altering neurotransmitters) and make their activity less likely.
If you miss a dose of this medication, you should take it as soon as possible. If this occurred while taking your next dose, skip the missed dose and go back to your regular dosing schedule.
Topamax tablets should be stored at room temperature 59-86 degrees F (15-30 degrees C). The capsules should be stored at temperatures below 77 degrees Fahrenheit (25 degrees C).
The enumerated below drugs, when taken with Topamax, increase the risk of kidney stones: acetazolamide (Diamox), dorzolamide (Trusopt), methazolamide (Neptazane), dichlorphenamide (Daranide). Carbamazepine (Tegretol) and phenytoin (Dilantin) markedly decrease the amount of Topamax in the body by increasing its excretion from the body. As a result, Topamax can lose effectiveness if doses are increased. Topamax may decrease the amount of estrogen in the body in women taking oral contraceptives, it may increase the chances of unwanted pregnancy. In patients with seizure disorders and taking anticonvulsant drugs, including Topamax, can develop nerve toxicity of chemicals; it concerns the 4'-O-methylpyridoxine, found as a contaminant in some preparations. Do not take this medicine if you have had an allergic reaction to it or are allergic to any ingredient in this product.
Do not stop using this medication without first consulting your doctor. Some side effects may aggravate if the medication is suddenly withdrawn. Keep medical and laboratory prescriptions when using this drug. Laboratory and / or medical tests may be done, for example, to measure bicarbonate levels in the blood before you start taking this medicine and during therapy to monitor side effects. Before you have any medical or dental treatments, emergency care, or surgery, tell your doctor or dentist that you are taking this medicine. This medicine may increase the impact of alcohol and other depressants. Ask your doctor if you have any questions.
Do not drive, do not operate machinery, or do anything else that could be dangerous until you know your reaction to this medicine. Using this medicine alone, with other drugs or with alcohol may reduce your ability to drive or perform other potentially dangerous tasks.
This medicine may reduce sweating, which can cause elevation of body temperature, especially in children. The risk of this serious side effect is more likely in hot weather and / or during vigorous exercise. Drink plenty of fluids in hot climates or when exercising. Check carefully for signs of reducing perspiration. If this happens, immediately quench your thirst or stop exercising. Seek emergency medical attention if your body temperature rises above normal or if you have mood changes, headache or dizziness. Consult your doctor for more information. Before you start taking any new medicine, consult the doctor. In women taking this medication and using birth control pills, it can reduce the effectiveness of contraception. To prevent pregnancy, other methods of contraception are to be used. Ask your doctor if you need more information. If you are planning to become pregnant, discuss with your doctor both benefits and risks of using this medicine during pregnancy. It is not known whether the drug is released in breast milk. If you plan to breast-feed while using the medicine, consult the doctor to discuss risks to your baby.
In adults the most common side effects when taking Topamax are fatigue, dizziness, coordination problems, speech, vision changes or double vision, difficulty with memory and sensory distortion. In children, the most common side effects are drowsiness, fatigue, loss of appetite, nervousness, difficulty concentrating, weight loss, aggressive reaction and difficulty with memory and vision problems. Symptoms usually occur within the first month of therapy, patients report an acute onset of reduced vision and / or eye pain. Eye examination revealed myopia (nearsightedness), redness, decreased depth of the anterior chamber and elevated ocular pressure without pupil dilation. The accumulation of fluid within the eye may displace the lens and the aperture in the front, causing secondary angle closure glaucoma. If patients develop this syndrome, treatment should be stopped as rapidly as possible.
Laboratory and or medical tests (e.g. eye) can be performed to monitor your progress. The drug should be taken strictly on doctor's prescription. Do not use this medicine for other diseases. Keep this medicine out of reach of children. If you use this medicine for an extended period of time, please have a sufficient quantity of the drug.
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