Topamax

Drug name: Topamax

Active Ingredients: topiramate

Therapeutic actions: The precise mechanisms by which topiramate exerts its anticonvulsant and migraine prophylaxis effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and migraine prophylaxis. Electrophysiological and biochemical evidence suggests that topiramate, at pharmacologically relevant concentrations, blocks voltage-dependent sodium channels, augments the activity of the neurotransmitter gamma-aminobutyrate at some subtypes of the GABA-Areceptor, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits the carbonic anhydrase enzyme, particularly isozymes II and IV.

Indications: Topamax is used to control seizures. This medication is also used to prevent migraine headaches and reduce how often you may get them. Topiramate will not work to treat a migraine headache once it occurs. If you get a migraine headache, treat it as directed by your doctor (e.g., take pain medications, decrease sound and light). Prescription needed.

Contraindications and cautions: Topamax use cannot be started or stopped suddenly. Stopping abruptly could cause seizures, even if you've never had them before.

• Before taking Topamax, tell your doctor if you have liver or kidney disease. You may not be able to take Topamax, or you may require a dosage adjustment or special monitoring during treatment.
• Topamax is in the FDA pregnancy category C. This means that it is not known whether Topamax 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 Topamax passes into breast milk. Do not take Topamax without first talking to your doctor if you are breast-feeding a baby.
• The safety and effectiveness of Topamax have not been established for children younger than 2 years of age.

Because Topamax sometimes causes confusion, dizziness, fatigue, and problems with machinery, or participate in any hazardous activity that requires full mental alertness until you are certain how the drug affects you.
Tell your doctor if you have kidney problems or if you are on hemodialysis. Your dosage of Topamax may need adjustment. Also make sure the doctor is aware of any liver disorder you may have. Topamax must be used cautiously by individuals with impaired liver function.
Recently a warning was issued that patients should be watched closely for decreased sweating and hypothermia. Be sure your doctor is aware of this and that you are being watched for changes in body temperature, especially in hot weather. Children on this drug should be watched especially closely. You should also contact your doctor right away if you experience vision problems.

Adverse effects: The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Some side effects, such as fatigue, are more likely to surface with high doses of Topamax. Others occur regardless of dosage. While many tend to disappear after the first 8 weeks of therapy, it's still important to report them to your doctor. Only your doctor can determine if it is safe for you to continue taking Topamax.
More common side effects may include:
Abdominal pain, abnormal coordination, abnormal vision, agitation, anxiety, appetite loss, back pain, breast pain, chest pain, confusion, constipation, depression, difficulty with concentration, difficulty with memory, dizziness, double vision, drowsiness, fatigue, flu-like symptoms, indigestion, involuntary eye movement, language problems, leg pain, loss of coordination, menstrual problems, mood problems, nausea, nervousness, rash, sinusitis, slowing of movements, sore throat, speech problems, tingling or burning sensations, tremors, upper respiratory infection, weakness, weight loss
Less common side effects may include:
Abnormal gait, abnormal menstrual bleeding, acne, aggressiveness, apathy, bladder infection, changes in taste, bloody urine, body odor, bronchitis, cough, decreased awareness, decreased mobility, decreased sensitivity, diarrhea, digestive inflammation, dry mouth, exaggerated sense of well being, eye pain, feelings of illness, feelings of unreality, fever, fluid retention, frequent urination, gas, gum inflammation, hair loss, hallucinations, headache, hearing difficulties, heart palpitations, hot flushes, hyperactivity, impotence, increased sweating, irritable bladder, joint pain, kidney stones, loss of balance, loss of consciousness, low sex drive, mood swings, muscle ache, muscle tension, muscle weakness, nosebleeds, painful or difficult urination, personality problems, pinkeye, ringing in the ears, sensitivity to touch, severe itching, shivers, shortness of breath, sleeplessness, suicidal tendencies, swelling, vaginal infection, vomiting, weight gain.
Topamax has also been known to cause a number of very rare side effects (typically striking less than one person in a hundred). If you develop any unfamiliar problems while taking Topamax, report them to your doctor.

Interactions: Tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine.
Before taking Topamax, tell your doctor if you are taking any of the following medicines:

• another seizure medication such as valproic acid (Depakote, Depakene), carbamazepine (Tegretol, Carbatrol, Epitol), phenytoin (Dilantin), and others;
• a carbonic anhydrase inhibitor such as acetazolamide (Diamox), methazolamide (Neptazane), or dichlorphenamide (Daranide); or
• digoxin (Lanoxin, Lanoxicaps).

You may not be able to take Topamax, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the drugs listed above. Topamax may decrease the effectiveness of birth control pills. Talk to your doctor about other birth control options to prevent unintended pregnancy. Topamax may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, sedative (sleep aids), anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if Topamax is taken with any of these medications. Drugs other than those listed here may also interact with Topamax. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Additional Information: DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.