Chemically, topiramate can be considered as a fructose-related monosaccharide derivative that also contains a sulfamate group. Not surprisingly, it is classified as a substituted sulfamate monosaccharide.
The exact modality by which topiramate manages to carry out its antiepileptic and preventive action of migraine is not yet fully understood, but it is believed that these activities are the result of a set of different mechanisms of action.
However, to carry out its therapeutic actions, topiramate must be administered orally; in fact, the medicines that contain it are in the form of tablets and capsules. For the dispensing of the latter, it is necessary to present a specific repeatable medical prescription (RR). However, since they are classified as Tier A drugs, their cost can be reimbursed by the National Health System (NHS).
Examples of Specialty Medicines Containing Topiramate
- Ecuram®
- Ramas®
- Sincronil®
- Topamax®
- Partial seizures, with or without secondary generalization;
- Generalized primary tonic-clonic seizures;
- Crises associated with Lennox-Gastaut syndrome.
Please Note
- The use of topiramate in migraine prophylaxis should only be used when other treatments cannot be performed or have not yielded satisfactory results.
- In no case, topiramate should be used in the acute treatment of the aforementioned diseases.
In any case, as a precaution, before taking medicines based on topiramate, it is advisable to inform the doctor of one's health conditions, making him aware of the possible presence of disorders or diseases of any kind, even if not expressly mentioned in the aforementioned list.
During treatment, the patient's body weight should be monitored regularly. In fact, treatment with topiramate can cause even very substantial weight loss. Should this occur, the doctor should be informed.
Please Note
Taking topiramate can cause side effects (dizziness, tiredness, visual problems, etc.) that can affect the ability to drive and / or use machines. Therefore, extreme caution is recommended and to avoid such activities in case of appearance of the aforementioned side effects.
Finally, it is recalled that some patients treated with topiramate have experienced thoughts of suicide and self-harm. Therefore, should they appear, you must immediately inform your doctor.
and lithium salts;However, before starting topiramate therapy, you should tell your doctor if you are taking, or have recently been taking, any medications or products of any kind, including non-prescription drugs (SOP ), over-the-counter medicines (OTC), herbal and phytotherapeutic products (in particular, St. John's wort) and homeopathic products.
Topiramate and Drinks
Alcohol should be avoided during treatment with topiramate.
manifesting side effects different in type and intensity, or not manifesting them at all.
Here are some of the main side effects that can arise during treatment with topiramate. For more complete and in-depth information, it is advisable to ask your doctor and carefully read the package leaflet of the medicine prescribed by him.
Disorders of the nervous system
Topiramate treatment could cause:
- Drowsiness;
- Dizziness
- Paresthesia;
- Disorders of cognitive functions;
- Reduction of the state of consciousness;
- Convulsions;
- Movement Disorders;
- Balance disorders;
- Sleep disorders.
Psychiatric disorders
The intake of topiramate could favor the onset of:
- Depression;
- Insomnia;
- Anxiety;
- Confusional states;
- Disorientation;
- Changes in mood;
- Agitation and aggression;
- Suicidal and self-harming thoughts;
- Personality disorders and psychotic disorders;
- Disorders of libido;
- Panic attacks;
- Mania or hypomania.
Cardiovascular Disorders
Topiramate therapy could lead to:
- Palpitations;
- Bradycardia;
- Hypotension;
- Orthostatic hypotension;
- Hot flashes
- Raynaud's phenomenon.
Blood disorders
During treatment with topiramate you may experience:
- Anemia;
- Leukopenia;
- Thrombocytopenia;
- Eosinophilia;
- Lymphadenopathy.
Gastrointestinal disorders
Topiramate therapy could result in:
- Nausea and / or vomiting;
- Diarrhea or constipation
- Abdominal pain;
- Dyspepsia;
- Gastritis;
- Gastroesophageal reflux disease;
- Pancreatitis;
- Flatulence;
- Abdominal distension;
- Salivary hypersecretion;
- Halitosis.
Kidney and urinary tract disorders
Treatment with topiramate may promote the appearance of:
- Dysuria;
- Pollakiuria;
- Nephrolithiasis;
- Urinary stones;
- Ureteral stones;
- Renal colic.
Disorders of the skin and subcutaneous tissue
Taking topiramate could cause:
- Skin rashes;
- Alopecia;
- Erythema;
- Urticaria;
- Edema;
- Skin discoloration;
- Erythema multiforme;
- Allergic dermatitis;
- Stevens-Johnson syndrome or toxic epidermal necrolysis.
Disorders of the musculoskeletal system and connective tissue
Topiramate therapy could lead to:
- Myalgia and muscle spasms;
- Arthralgia;
- Muscle weakness
- Musculoskeletal pain;
- Joint swelling
- Musculoskeletal stiffness.
Other side effects
Other side effects that may occur during treatment with topiramate include:
- Allergic reactions, even severe ones, in sensitive individuals;
- Weight loss (decrease in body weight);
- Increased levels of ammonia in the blood (increased ammonia);
- Sexual dysfunction and erectile dysfunction;
- Fatigue;
- Asthenia;
- Pyrexia;
- Malaise with flu-like symptoms
- Anorexia;
- Reduction of appetite;
- Dyspnea;
- Epistaxis;
- Runny nose and nasal congestion;
- Dizziness;
- Tinnitus;
- Ear pain and hearing disorders;
- Increased lacrimation, blurred vision and other visual disturbances;
- Learning disabilities (children and adolescents).
Overdose
In the event of a topiramate overdose, the following symptoms may occur:
- Drowsiness;
- Speech disturbances;
- Diplopia;
- Blurred vision
- Reduction of mental abilities;
- Amazement;
- Agitation;
- Dizziness
- Abdominal pain;
- Disorders of coordination;
- Convulsions.
If the overdose is recent, the stomach should be emptied immediately by gastric lavage or induction of vomiting. Charcoal could also be useful. There is no specific antidote, therefore, treatment is symptomatic and supportive. However, hemodialysis has been shown to be useful in removing the active ingredient from the body.
In light of the foregoing and given the dangerous symptoms that can occur following an overdose of topiramate - ascertained or presumed to be - it is necessary to go to the nearest emergency room, taking care to bring the package of the medicine taken with you.
(Na +);
Please Note
During therapy with topiramate, in order to avoid kidney stones, it is necessary to drink plenty of fluids.
The exact dosage (dose, frequency of administration and duration of treatment) of topiramate will be established by the doctor for each patient, depending on the disorder to be treated (epilepsy or migraine prophylaxis), age and body weight of the patient. patient and their response to treatment.
Generally, the doctor prescribes a low starting dose of topiramate which is then gradually increased to the ideal maintenance dose to control the symptoms in each patient.
?The use of topiramate for the treatment of epilepsy in pregnant women should be carried out only if absolutely necessary and indispensable and only after a careful evaluation of the relationship between the expected benefits for the mother and the potential risks for the fetus. in fact, animals have shown that topiramate can cause harm to the fetus. Therefore, it is necessary to exercise the utmost caution and - if antiepileptic therapy is necessary - the doctor will have to carefully evaluate all the treatments available before proceeding with the prescription of the active ingredient in question.
Conversely, the use of topiramate for migraine prophylaxis in pregnant women is contraindicated; as it is contraindicated in women of childbearing age who do not use suitable contraceptive means (remember, however, that topiramate can reduce the action of oral contraceptives).
Regarding breastfeeding, topiramate may be excreted in breast milk. Therefore, breastfeeding mothers are advised to exercise caution and to inform their doctor of their condition if they are prescribed treatment with this active ingredient.
In any case, please note that pregnant women and mothers who are breastfeeding must always seek medical advice before taking any type of drug or substance.
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