Topiramate

Generic Details

Generic Name

Topiramate

Other Names

Topamax
Topiragen

Drug Class

Anticonvulsant
Antiepileptic
Antimigraine

Chemical Formula

C12H21NO8S

Molecular Weight

339.36 g/mol

Mechanism of Action

Blocks voltage-gated sodium channels
Enhances the activity of gamma-aminobutyric acid (GABA)
Antagonizes alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate receptors

Indications

Epilepsy
Migraine prophylaxis
Weight loss (off-label)
Bipolar disorder (off-label)

Common Dosage Forms

Tablet
Capsule
Sprinkle capsule

Typical Dosage

25-200 mg/day for epilepsy
25-100 mg/day for migraine prophylaxis

Pediatric Dosage

Dosage based on body weight and condition, consult a pediatrician

Geriatric Dosage

Dosage adjustments may be necessary, consult a healthcare provider

Side Effects

Dizziness
Sedation
Weight loss
Cognitive slowing
Kidney stones
Glaucoma
Mood changes

Contraindications

Hypersensitivity to topiramate
Metabolic acidosis
Severe kidney disease

Pregnancy Category

Category D - Positive evidence of risk

Lactation Safety

Limited data available, caution advised

Drug Interactions

Concomitant use with other antiepileptic drugs may require dosage adjustments

Overdose Symptoms

Dizziness
Agitation
Blurred vision
Seizures

Antidote for Overdose

Symptomatic and supportive treatment

Storage Conditions

Store at room temperature away from moisture and heat

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration
Distribution: Crosses the blood-brain barrier and is distributed widely throughout the body
Metabolism: Undergoes minimal hepatic metabolism
Excretion: Primarily excreted unchanged in the urine

Precautions

Monitor kidney function regularly
Avoid abrupt discontinuation
Caution in patients with history of metabolic acidosis

Warnings

Risk of suicidal thoughts and behaviors in patients

Others

Topiramate may cause vision-related adverse effects, including acute myopia and secondary angle closure glaucoma.