Monograph Details
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Pain & Pyrexia
> Migraine and headache
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TOPAMAX TABLETS |
| Manufacturer |
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Ortho-McNeil Neurologics, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Sulfamate. |
| Generic Name |
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Topiramate 25mg, 50mg, 100mg, 200mg. |
| Also |
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• TOPAMAX SPRINKLE CAPS
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| Indications |
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Migraine prophylaxis. |
| Children |
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Not recommended. |
| Adults |
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May swallow caps whole or sprinkle contents onto soft food (swallow immediately). Titrate in 1-week intervals. Initially 25 mg once daily in the PM, then 25 mg twice daily, then 25 mg in the AM and 50 mg in the PM, then 50 mg twice daily. Renal impairment (CrCl <70mL/min): reduce dose by ½. Hemodialysis: may need extra dose. |
| Precautions |
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Discontinue if acute myopia and secondary angle-closure glaucoma occur. Hepatic or renal impairment. Kidney stones. Maintain adequate hydration and caloric intake; avoid ketogenic diets. Monitor serum bicarbonate; follow up if acidosis occurs. Monitor closely for oligohidrosis and hyperthermia (esp. children). Suicidal tendencies (monitor). Avoid abrupt cessation. Labor & delivery. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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Avoid carbonic anhydrase inhibitors. Phenytoin, carbamazepine, valproic acid reduce topiramate levels. Topiramate reduces valproic acid levels. May increase phenytoin levels. May increase levels with lamotrigine. May antagonize digoxin, oral contraceptives, lithium, risperidone. CNS depression potentiated with alcohol, other CNS depressants. Hyperammonemia possible with valproic acid. Caution with other drugs that interfere with temperature regulation (eg, anticholinergics, carbonic anhydrase inhibitors). |
| Adverse Reactions |
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Drowsiness, dizziness, ataxia, speech disorder, psychomotor slowing, nervousness, other mental changes, paresthesia, hypoaesthesia, visual disorders/eye pain (follow-up if occurs), fatigue, weight loss, GI upset, anorexia, URIs, kidney stones, hyperchloremic acidosis. |
| How Supplied |
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Tabs, caps—60 |
| Additional Resources |
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• Related Prescribing Note |
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