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Topiramate

About Topiramate

Topiramate belongs to a group of medicines called “antiepileptic (AED)/ anticonvulsant agent' that is primarily indicated in the treatment of epilepsy (Monotherapy and Adjunctive therapy) and It can also be taken to prevent migraine. Epilepsy is a chronic disorder that is responsible for causing unprovoked, recurrent seizures in the body. A seizure is a sudden attack in the brain that makes a person lose control of their actions. Migraine is a mental condition that often causes intense or debilitating headaches with difficulty speaking, nausea, vomiting, and sensitivity to light or sound.

Topiramate is responsible for restoring the balance of neural activity by diminishing the spread of seizure movement in the brain. By controlling the electrical activity of the brain, it controls seizures and relieves the symptoms of migraine. Take Topiramate in an empty stomach without food with one glass of water. Topiramate is only available on prescription. It comes as tablets or capsules intended to be taken by mouth only. Swallow the medication as a whole without crushing or breaking it. Topiramate doses are sometimes advised according to the weight of children so the doctor will change the dose if the child gains or lose weight.

The possible side effects of topiramate include feeling sleepy, dizziness, diarrhoea and feeling sick. Some of the side effects do not even require medical attention and these are usually mild and go away by themselves. Consult with the doctor if any of these side effects continue or get worse with time.

The use of $mame is restricted in persons who are hypersensitive to it, so tell your doctor if you have any allergy to any of the chemical constituents present in this medicine. Tell your doctor if you ever had or already dealing with diarrhoea, glaucoma, metabolic acidosis, lung disease, breathing problems, liver disease, a blood disorder called acute porphyria etc. If a woman is pregnant or planning to pregnant then they should tell their doctor as the use of this medicine during pregnancy may increase the risk of cleft lip and/or cleft palate which is a birth defect in the newborn that may develop during early pregnancy.

Uses of Topiramate

Epilepsy, Migraine

Medicinal Benefits

Topiramate is an antiepileptic (AED) medicine that is used to treat epilepsy in mono or adjunctive therapy and migraine. In Monotherapy epilepsy, Topiramate is suggested for patients above 2 years of age with partial-onset or primary generalized tonic-clonic seizures. In Adjunctive therapy epilepsy, Topiramate is suggested in patients of 2 to 16 years of age with partial-onset seizures or primary generalized tonic-clonic seizures while in patients more than 2 years of age, Topiramate is suggested in patients with seizures associated with Lennox-Gastaut syndrome (LGS). In migraine, Topiramate is suggested for prophylaxis of migraine. Topiramate works by blocking the voltage-dependent sodium and calcium channels and increasing the inhibitory actions of GABA. In epilepsy, Topiramate controls the uncontrolled activity of nerves in the brain and thus prevents or controls seizures. While in migraine, Topiramate tranquilizes the overactive nerve cells in the brain that are responsible for causing migraine.

Directions for Use

Tablet: It can be taken irrespective of meals. Swallow the tablet as a whole with a glass of water. Do not chew the tablet. Sprinkle capsule: You may swallow the capsule as a whole or you may open the capsule and sprinkle the entire contents on a teaspoon of soft food. Drink fluids immediately after eating this medicine and food mixture to make sure it is swallowed. Do not store this mixture for later use.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Topiramate

  • Tingling of the arms and legs
  • Not feeling hungry
  • Nausea
  • Change in taste
  • Diarrhoea
  • Weight loss
  • Nervousness
  • Upper respiratory tract infection

Drug Warnings

Topiramate may cause a congenital disability called cleft lip in unborn baby, so the use of this medicine is not allowed in pregnant females. Topiramate may increase the body temperature and reduce sweating, so one should report it to the doctor if they are noticing decreased sweating and hot, dry skin. Topiramate may enhance the level of acid in the blood so one should tell their doctor if they have irregular heartbeats or loss of hunger. Before taking Topiramate, tell the doctor if you have diarrhoea, metabolic acidosis, eye problems, liver disease. Topiramate may affect the working of contraceptives that include the combined pill, vaginal ring, patches,progestogen-only contraceptive pill, and emergency contraception. So, one should tell their doctor if they are using any contraceptives to prevent pregnancy.

Drug Interactions

Drug-Drug Interaction: A person should tell the doctor about all the medications they are using, including the medicines used to treat diabetes (metformin, glibenclamide, pioglitazone), medicines used to treat depression or anxiety  (venlafaxine, amitriptyline), medicines for heart or blood pressure (diltiazem, hydrochlorothiazide, propranolol), antipsychotic medicines (risperidone), and or any other epilepsy medicines.

Drug-Food Interaction: The use of alcohol with Topiramate is restricted as alcohol may worsen the side effects of the medicine.

Drug-Disease Interaction: The use of Topiramate is restricted in patients dealing with bone marrow depression/blood dyscrasias, hyperthermia, severe liver disease, suicidal tendency, renal dysfunction, metabolic acidosis, angle-closure glaucoma, hemodialysis, and nephrolithiasis.

Drug-Drug Interactions Checker List:

  • METFORMIN
  • GLIBENCLAMIDE
  • PIOGLITAZONE
  • VENLAFAXINE
  • AMITRIPTYLINE
  • DILTIAZEM
  • HYDROCHLOROTHIAZIDE
  • PROPRANOLOL
  • RISPERIDONE
  • Safety Advice

    • Safety Warning

      Alcohol

      caution

      Do not consume alcohol while taking Topiramate as alcohol can worsen the side effects of the Topiramate including sleepiness and dizziness

    • Safety Warning

      Pregnancy

      unsafe

      Topiramate is a Category D pregnancy drug. It is not recommended for use during pregnancy as it may cause an increase in the risk of the cleft lip that is a congenital disability in the unborn baby.

    • Safety Warning

      Breast Feeding

      caution

      Caution is advised when Topiramate is using in nursing mothers as this medicine may pass into breast milk.

    • Safety Warning

      Driving

      caution

      Some persons may continue to face unpredictable seizures even after taking Topiramate and this medicine also affects thinking and motor skills and may affect vision. So patients should take caution before engaging in any activity including driving or operating any machine.

    • Safety Warning

      Liver

      caution

      Topiramate should be used with caution in patients with liver disease as the dosage needs to be reduced in patients dealing with liver disease.

    • Safety Warning

      Kidney

      caution

      Topiramate should be used with caution in patients with kidney disease as the dosage needs to be reduced in patients dealing with kidney disease.

    • Safety Warning

      Children

      safe if prescribed

      Topiramate is safe to use in children above 2 years only if prescribed by the doctor.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Eat a balanced diet that consists of good fats, proteins, carbohydrates, vegetables, and fruit which helps the body and brain to work properly and keep a person healthy and energetic.
    • Fatigue is one of the primary reasons that trigger seizures in the body, so sleeping properly can help in relaxing the brain.
    • One should avoid the consumption of alcohol as it can trigger seizures in patients. Even one or two glasses can trigger epilepsy and worsen the side effects of Topiramate.
    • Keep yourself happy and avoid taking emotional stress as stress causes seizures. Persons who maintain healthy stress levels have reported that they have responded well to the medicine.

    Patients Concern

    Disease/Condition Glossary

    Epilepsy: It is a neurological disorder in which brain activity becomes abnormal characterized by intense electrical bursts in the brain (seizures). When these bursts happen in one part of the brain it is called a partial seizure while if these bursts occur in the complete brain it is called a generalized seizure. Sometimes, a person starts experiencing the symptoms before starting of seizure that includes a sudden feeling of fear, dizziness, changes in vision, shakiness in arms and legs, and headache. While the symptoms that occur during a seizure include losing consciousness, characterized by confusion, uncontrollable muscle spasms, falling, biting tongue, sudden, rapid eye movements, unusual noises, such as grunting, sudden mood changes, etc.

    Migraine: It is a mild to severe headache that starts as a dull ache in the region around the eye. It usually lasts a few hours up to several days and gets worst with the movement. The possible warning signs that can start before the occurrence of migraine include visual changes, unusual tiredness, tingling in an arm or leg. A person facing migraine may also face mild to severe pain in the head, pulsing, throbbing pain in the head, sensitivity to sound and light, vomiting, and Nausea.

    FAQs

    Seizures can happen when the brain cells are not working properly or working faster than normal. Topiramate slows down these electrical signals to stop seizures.

    No, you should take rest after taking this medicine as this medicine affects the thinking ability and vision of a person so avoid doing any task that requires mental alertness.

    Topiramate acts by decreasing the spread of seizure activity in the brain. It also restores the normal balance of neurons which in turn calms the brain. In epilepsy, cells present in the brain talk to each other by generating electric signals. When these cells fail to work properly or working faster than normal then it causes seizures. Topiramate slows down these electrical signals and thus prevents or controls seizures. While in migraine, Topiramate tranquilizes the overactive nerve cells in the brain that are responsible for causing migraine.

    Yes, the use of Topiramate is safe for long time use if suggested by the doctor.

    Yes, Topiramate may affect the working of contraceptives that include the combined pill, vaginal ring, patches,progestogen-only contraceptive pill, and emergency contraception. Tell your doctor if you are using any type of contraceptives as the doctor may suggest using different types of contraceptives or combined hormonal contraceptives.

    No, Topiramate does not affect fertility.

    Generally, one should avoid consuming alcohol while taking Topiramate as it may make a person feel sleepy or tired and can cause seizures in some people with epilepsy.

    Available Medicines for

    Topiramate

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