Topiramate

Aka: Topiramate, Topamax

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II. Indications

  1. Simple Partial Seizures
  2. Complex Partial Seizures
  3. Generalized Tonic Clonic Seizures

III. 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

IV. Adverse Effects: Other

  1. Nephrolithiasis
  2. Narrow Angle Glaucoma

V. Drug Interactions

  1. Other Seizure medications

VI. 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

VII. 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

VIII. Precautions

  1. Adjust dose if Creatinine Clearance <60 ml/min/sec

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Cost: Medications

topiramate (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
TOPIRAMATE 100 MG TABLET Generic $0.08 each
TOPIRAMATE 15 MG SPRINKLE CAP Generic $0.34 each
TOPIRAMATE 200 MG TABLET Generic $0.11 each
TOPIRAMATE 25 MG SPRINKLE CAP Generic $0.42 each
TOPIRAMATE 25 MG TABLET Generic $0.03 each
TOPIRAMATE 50 MG TABLET Generic $0.06 each
TOPIRAMATE ER 100 MG CAPSULE Generic $10.07 each
TOPIRAMATE ER 150 MG CAPSULE Generic $12.80 each
TOPIRAMATE ER 200 MG CAPSULE Generic $14.53 each
TOPIRAMATE ER 50 MG CAPSULE Generic $5.19 each
topamax (on 3/22/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
TOPAMAX 100 MG TABLET Generic $0.08 each
TOPAMAX 200 MG TABLET Generic $0.11 each
TOPAMAX 25 MG SPRINKLE CAP Generic $0.42 each
TOPAMAX 25 MG TABLET Generic $0.03 each
TOPAMAX 50 MG TABLET Generic $0.06 each
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.

Ontology: 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 Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C052342
SnomedCT 108400009, 386844006
LNC LP19239-0, MTHU007741
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
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Topamax (C0723778)

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

Related Topics in Pharmacology

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