Topamax

General Info about Topamax

Topamax is an original antiepileptic drug, the effectiveness and safety of which have been confirmed by numerous scientific clinical studies and many years of experience.

Topamax is an antiepileptic medication from the class of sulfamate-substituted monosaccharides. It is able to effectively combat epilepsy, tonic-clonic generalized and partial seizures. Single dose, daily dosage, and frequency of reception are determined individually. Topamax contains topiramate, magnesium stearate, sodium starch glycollate, MCC, carnauba wax, pregelatinized starch, and lactose monohydrate. The dosage and the course are determined by a specialist.

Medical uses of Topamax:

  • Epilepsy:
    • as a monotherapy: in adults and children older than 2 years (including patients with newly diagnosed epilepsy);
    • in the complex therapy: in adults and children over 2 years with partial or generalized tonic-clonic seizures
  • In pediatrics, indications for its use include the Lenox-Gastaut syndrome, other paroxysmal conditions, and developmental delay.
  • Prevention of migraine attacks in adults. The use of Topamax for the treatment of acute migraine attacks has not been studied.
  • In addition to approved indications, topiramate can be used for the treatment of obesity, bipolar affective disorder, nicotine addiction, post-traumatic stress disorders, neuropathic pain, bulimia, and periventricular leukomalacia in premature infants.
  • In bipolar disorders, Topamax is used to normalize the mood in all phases of the disease.
  • The possible therapeutic effect of Topamax is studied in patients with alcohol withdrawal syndrome and drug dependence.
  • Against the background of taking Topamax, there is a dose-dependent decrease in body weight; this process is reversible with decreasing doses of the drug.

Mechanism of action of Topamax

The mechanism of action of topiramate is associated with blockade of sodium and calcium channels, increased activity of GABAergic neuromediation and blockade of glutamatergic system, which leads to a weakening of epileptiform discharges in nerve cells. Bioavailability of topiramate is about 80%, food intake does not affect its absorption. When taken orally, the drug is absorbed quickly and efficiently and weakly binds to plasma proteins (13-17%). The pharmacokinetics of topiramate is linear: the concentration of the drug in the plasma is proportional to the dose taken. A stable level in the blood is reached within 4-8 days of regular intake of the drug. Topiramate is metabolized by the liver by hydroxylation, hydrolysis, and glucoronization with the formation of 6 inactive metabolites. It is excreted by the kidneys mainly unchanged (70% of the drug). The half-life is 19-23 hours. If the kidneys or liver function is impaired, the clearance of the drug is reduced.

Common side effects and overdose

On the background of taking Topamax, headache, dizziness, drowsiness, inhibition, impaired concentration, paresthesia, a feeling of fatigue, a perversion of taste sensations, in rare cases – visual impairment, amnesia, ataxia, depression, and emotional lability may occur. It is believed that the side effects are dose-dependent. It is recommended to determine the level of the drug in the blood if there is a suspicion of overdose as well as in patients with impaired liver and kidney function. It is important to know:                     

  • Topamax is contraindicated for people who are hypersensitive to its elements and for children under 2 years.
  • It should be taken with caution during pregnancy, lactation, in the case of the renal/hepatic insufficiency, and hypercalciuria.
  • In patients predisposed to nephrourolythiasis, there is a risk of appearance of kidney stones, which requires an adequate increase for fluid consumed to prevent it.
  • During the treatment with Topamax, care must be taken when driving vehicles and engaging in other potentially dangerous activities that require an increased concentration of attention.