Antiepileptic

Topiramate 100 mg, n30

International Nonproprietary Name (INN): topiramate.

Pharmaceutical group: Antiepileptic.

Presentation:

Tablets, film-coated, 25 mg, 100 mg n30.

Available with prescription

Question?

THERE ARE CONTRAINDICATIONS. CAREFULLY READ THE INSTRUCTIONS FOR USE, OR OBTAIN A SPECIALIST ADVICE

Topiramate is indicated for treatment of epilepsy, seizures or prevention of migraine attacks. The prescriptions are usually available from neurologists or specialists in epileptology or psychiatry.

Topiramate is a novel agent classified as a sulfamate substituted monosaccharide. Three pharmacological properties of topiramate are believed to contribute to its anticonvulsant activity. First, topiramate reduces the frequency at which action potentials are generated when neurons are subjected to a sustained depolarization indicative of a state-dependent blockade of voltagesensitive sodium channels. Second, topiramate markedly enhances the activity of GABA at some types of GABA receptors. Because the antiepileptic profile of topiramate differs markedly from that of the benzodiazepines, it may modulate a benzodiazepine-insensitive subtype of GABAA receptor. Third, topiramate antagonizes the ability of kainate to activate the kainate/AMPA subtype of excitatory amino acid (glutamate) receptors but has no apparent effect on the activity of N-methyl-D-aspartate (NMDA) at the NMDA receptor subtype. There are also alternative explanations of pharmacodynamics of this drug. We should take into account that the mechanism of action for Topiramate is still under discussion and research, in spite of widespread usage of the drug in medical practice (since 24 December 1996 in USA, for example).

Before prescribing this remedy, be sure to read carefully a specialist’s leaflet.

Epilepsy – Monotherapy:

The recommended initial target dose for topiramate monotherapy in adults and children 6 years of age and older is 100 mg/day and the maximum recommended dose is 400 mg/day, administered in two divided doses, as needed and tolerated.

The recommended titration rate for topiramate monotherapy to 100 mg/day is:

 

Week 1

Weeks 2-3

Weeks 3-4

Morning Dose

None

25 mg

50 mg

Evening Dose

25 mg

25 mg

50 mg

If doses above 100 mg/day are required, the dose may be increased at weekly intervals in increments of 50 mg/day to a maximum of 400 mg/day. Dose and titration rate should be guided by clinical outcome. Some patients may benefit from a slower titration schedule. Daily doses above 400 mg have not been adequately studied.

 

Migraine - Adults

The usual total daily dose of Topiramate as treatment for prophylaxis of migraine headache is 100 mg/day administered in two divided doses. Dose and titration rate should be guided by clinical outcome. If required, longer intervals between dose adjustments can be used. No extra benefit has been demonstrated from the administration of doses higher than 100 mg/day and the incidence of some adverse events increases with increasing dose.

 

More information about Topiramate’s medical usage you can find in the approved leaflet (in Russian language only), which is included in each carton box with the product.