Anticonvulsant : topiramate, Topamax

Pharmacology

Anti Convulsant

Topamax is an anti-epileptic drug, prescribed to control both the mild attacks known as partial seizures and the severe tonic-clonic convulsions known as grand mal seizures. It is typically added to the treatment regimen when other drugs fail to fully control a patient's attacks.

Do not abruptly stop taking Topamax. If the drug isn't withdrawn gradually, the frequency of your seizures could increase.

It is important to take this medication exactly as prescribed. It can be taken with or without food. Avoid breaking the tablets; the medication has a bitter taste.

Topamax increases your risk of developing kidney stones. To prevent this problem, be sure to take this medication with plenty of fluids.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take two doses at once.

Adverse Effects

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.

Warnings

Because Topamax sometimes causes confusion, dizziness, fatigue, and problems with coordination and concentration, you should not drive, operate 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.

The safety and effectiveness of Topamax in children have not been established.

Food and Drug Interactions

Topamax can depress the central nervous system. Be extremely cautious about combining it with alcohol, sedatives, tranquilizers, and other central nervous system depressants.

For people with poor kidney function, the dosage is usually cut in half. On the other hand, those undergoing hemodialysis may need a supplemental dose.

If you are also taking Dilantin or Tegretol, the dosage of Topamax may need adjustment. Likewise, the doctor may adjust your dosage if you have liver problems.

If Topamax is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Topamax with:

• Acetazolamide (Diamox)
• Carbamazepine (Tegretol)
• Dichlorphenamide (Daranide)
• Digoxin (Lanoxin) Phenytoin (Dilantin)
• Oral contraceptives
• Valproic acid (Depakene)