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Topiramate

Aka: Topiramate, Topamax

Indications
Adverse Effects: Dose related
1. Interferes with concentration and memory
  1. Refered to pejoratively by some as "Dopamax"
2. Confusion
3. Sedation
4. Lethargy
5. Dizziness
6. Ataxia
7. Diplopia
8. Tremor
9. Nervousness
10. Fatigue
11. Depression
12. Anorexia
13. Dyspepsia
Adverse Effects: Other
1. Nephrolithiasis
2. Narrow Angle Glaucoma
Drug Interactions
1. Other Seizure medications
Dose: Adult
1. Initial: 25-50 mg/day (consider start just qhs)
2. Increase by 25-50 mg/day increments per week
3. Target
  1. Adults: 400 mg/day divided bid
  2. Elderly: 200 mg/day divided bid
4. Maximum dose: 1600 mg/day divided bid
Dose: Child
1. Initial: 1-3 mg/kg up to 25 mg PO qhs for 1 week
2. Increase by 1-3 mg/kg/day to 25 mg increments per week
3. Target range: 5-9 mg/kg/day divided bid
Precautions
1. Adjust dose if Creatinine Clearance <60 ml/min/sec

Medication Costs
Topiramate (on 2/9/2012 at DrugStore.com)
Topiramate 15mg Sprinkle Capsule	#60 for $70.99	($1.18/unit)
Topiramate 25mg Sprinkle Capsule	#60 for $85.99	($1.43/unit)
Topiramate 25mg Tablets	#60 for $29.99	($0.50/unit)
Topiramate 100mg Tablets	#60 for $49.99	($0.83/unit)
Topiramate 200mg Tablets	#60 for $50.99	($0.85/unit)
Topiramate 50mg Tablets	#60 for $39.99	($0.67/unit)
Topamax (on 2/9/2012 at DrugStore.com)
Topamax 25mg Tablets	#60 for $201.99	($3.37/unit)
Topamax 50mg Tablets	#60 for $400.01	($6.67/unit)
Topamax 100mg Tablets	#60 for $555.99	($9.27/unit)
Topamax 200mg Tablets	#60 for $626.00	($10.43/unit)
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

topiramate (C0076829)
Definition (CHV)	a kind of anticonvulsant drug
Definition (NCI)	A sulfamate-substituted monosaccharide with anticonvulsant property. Although the mechanism of action has not been fully elucidated, topiramate antagonizes kainate/AMPA subtype of the glutamate receptors, which are ligand-activated cation channels that mediate the fast component of excitatory postsynaptic currents in neurons of the central nervous system. This antagonistic action results in stabilizing hyper-excited neural membranes, inhibiting repetitive neuronal firing, and decreasing propagation of synaptic impulses, thereby impedes seizure occurrences. In addition, this agent augments gamma-aminobenzoic acid (GABA) activity and thereby attenuating GABAnergic inhibitory transmission.
Concepts	Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH	C052342
SnomedCT	108400009, 386844006
English	2,3-4,5-bis-O-(1-methylethylidene)-beta-D-fructopyranose sulfamate, topiramate, beta-D-Fructopyranose, 2,3:4,5-bis-O-(1-methylethylidene)-, Sulfamate, topiramate (medication), TOPIRAMATE, topiramate [Chemical/Ingredient], Topiramate, Topiramate (product), Topiramate (substance)
Spanish	topiramato (producto), topiramato (sustancia), topiramato
Sources	Derived from the NIH UMLS (Unified Medical Language System)

Topamax (C0723778)
Definition (CHV)	a migraine treatment medication
Concepts	Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH	C052342
English	Topamax, topiramate (Topamax), Cilag brand of topiramate, Epitomax, Janssen brand of topiramate, Ortho brand of topiramate
Sources	Derived from the NIH UMLS (Unified Medical Language System)