Topamax® (topiramate)
Topiramate is a neuronal stabilizing agent (aka anticonvulsant medication) that has proven effective as a Migraine preventive for some patients. It is one of only a few medications to actually have been approved by the FDA for Migraine prevention. As with other drugs in this category, patients should start at a low dosage and slowly taper up to therapeutic levels. The daily dose should be taken in two divides doses approximately 12 hours apart. If discontinuing this medication, it is essential to slowly taper off rather than discontinuing abruptly.
Type of medication: Rx, preventive, anticonvulsant
Special Notes:
- At the Migraine Trust's 14th biennial
International Research Symposium, noted Migraine specialist Dr. Stephen
Silberstein noted:
- The best results were achieved at a dosage of 100 or 200 milligrams of topiramate per day, a lower dosage than that used to treat epilepsy.
- The most commonly experience side effects were nausea and tingling of the extremities.
- "What was amazing in this trial was the effect on weight. The patients who got topiramate lost, on average, 3.8 percent of their body weight."
- In an interview with Teri Robert, Dr.
Silberstein elaborated:
- "The key to success with Topamax is a very slow titration up to the therapeutic dose. Patients should begin taking only 15 mg, once a day, and taper up slowly from there, being sure to take it in a split dose."
- The effective dosages are lower than you might think. Many patients achieve good results at only 50 mg per day."
How supplied:
25 mg and 100 mg , and 200 mg tablets; 15 mg and 25 mg sprinkles capsules.
Precautions:
- Seek immediate medical attention if you experience blurred vision, changes in vision, or pain in or around the eyes during treatment with topiramate. These may be early signs of a serious side effect.
- Do not stop taking topiramate without first talking to your doctor, even if your symptoms have improved. It is important to continue taking topiramate to prevent seizures from recurring.
- Carry or wear a medical identification tag to let others know that you are taking topiramate in the case of an emergency.
- Use caution when driving, operating machinery, or performing other hazardous activities. Topiramate may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
- Alcohol should be avoided while taking topiramate. Alcohol may cause increased sedation or drowsiness. It may also increase the risk of having a seizure.
- Drink several extra glasses of fluid each day during treatment with topiramate to minimize the risk of kidney stone formation. Additional fluid may be necessary during hot weather, vigorous exercise, and illness.
- Ketogenic diets (high protein, very low carbohydrate diets that may induce ketosis) may increase the risk of kidney stone formation and should be avoided during treatment with topiramate.
Pregnancy and Breastfeeding:
- FDA pregnancy category C. This means that it is not known whether topiramate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or if you could become pregnant during treatment.
- It is not known whether topiramate passes into breast milk. Do not take topiramate without first talking to your doctor if you are breast-feeding a baby.
Other medical conditions:
The presence of other medical problems may
affect the use of topiramate. Make sure you tell your doctor if you have any
other medical problems, especially those listed below or if you are
planning to have surgery.
- Diarrhea
- Fatty diet
- Severe Lung Problems
- Kidney problems or other kidney problems
- Liver problems
- Status epilepticus
