Topamax general information

What is Topamax used for?

Topamax tablets 50mg are used to treat epilepsy in adults and children to control seizures, which happen when there is abnormal electrical activity in the brain. Topamax tablets 50mg are used as monotherapy (on its own) for adults and children (over 6) who have just been diagnosed with idiopathic epilepsy (of unknown cause) and who have either generalised tonic-clonic seizures, seizures affecting the whole brain (formerly known as grand mal seizures), which usually last 1-3 minutes; or partial seizures, which affect only part of the brain but can spread to the whole brain and these are called secondarily generalised seizures. Topamax tablets 50mg are also used in addition to another medication for controlling seizures in adults and children (over 2 years of age) in partial onset seizures, generalised tonic-clonic seizures but who have been unable to achieve control of seizures with other medications; also in children for treatment seizures associated with of Lennox-Gastaut syndrome, a form of childhood-onset epilepsy that causes frequent seizures and developmental problems. Topamax tablets 50mg are also used for the prevention of migraines in adults who have regular migraines (3 or more per month).

How does Topamax work?

Topamax tablets 50mg contain topiramate, an anticonvulsant used to treat epilepsy and control seizures. Nerve cells throughout the central nervous system communicate by sending out electrical signals, generated by the movement of electrically charged particles in and out of nerve cells, which travel to the all parts of the body via chemical messengers called neurotransmitters. This usually happens in an orderly fashion to control all our actions and thought processes. Epileptic seizures are thought to be caused by abnormal electrical activity in the brain, with uncontrolled, rapid and repetitive electrical signals being sent continually to various parts of the body, although the trigger for this abnormality is not known. Topiramate in Topamax tablets 50mg works directly on the brain cells to reduce the rate at which electrical signals are generated, calming the overactive nerve activity, by three different mechanisms. Conduction of electrical impulses is dependent on the flow of positive sodium ions into and out of the nerve cell through special sodium channels. Topiramate blocks these sodium channels and therefore reduces the neurone’s ability to send out continuous signals which cause seizures. Topiramate also has the ability to enhance the activity of gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter that regulates how much neurones can be excited (stimulated to send out electrical impulses), and inhibits the activity of the excitatory neurotransmitter glutamate, which adds to the calming effect on brain electrical activity. These three mechanisms are thought to contribute to the anticonvulsant activity of Topamax tablets 50mg, which control seizures in epilepsy, but cannot cure them.

What does Topamax contain?

Topamax tablets 50mg contain the active ingredient topiramate, which is an anticonvulsant used to treat epilepsy and control seizures. They also contain lactose, pregelatinised maize starch, carnauba wax, microcrystalline cellulose, sodium starch glycollate, magnesium stearate, titanium dioxide, hypromellose, lauromacrogol 400 and polysorbate 80.

What doses of Topamax are available?

Topamax tablets are available from Inhouse Pharmacy in 4 doses: 25mg, 50mg, 100mg and 200mg.

Treating epilepsy with Topamax

Topamax tablets 50mg contain topiramate, an anticonvulsant used to treat epilepsy in adults and children to control tonic-clonic seizures, seizures affecting the whole brain (formerly known as grand mal seizures), and partial seizures, which affect only part of the brain but can spread to the whole brain and are called secondarily generalised seizures. Epileptic seizures happen when there is abnormal electrical activity in the brain, with uncontrolled, rapid and repetitive electrical signals being sent continually to various parts of the body, although the trigger for this abnormality is not known. Topiramate in Topamax tablets 50mg works directly on the brain to reduce the rate at which electrical signals are generated, by blocking the ability of nerve cells to transmit electrical signals. This action is thought to contribute to the anticonvulsant activity of Topamax tablets 50mg, which prevent the overload of electrical activity in the brain that causes seizures in epilepsy and therefore controls the seizures, but cannot cure epilepsy.

Topamax for preventing migraine

Topamax tablets 50mg contain topiramate, an anticonvulsant that is used to treat epilepsy to control seizures. They are also used for the prevention of migraines in adults who have regular migraines (3 or more per month) that interfere with normal daily activities. Topiramate in Topamax tablets 50mg works directly on the brain to reduce the rate at which electrical signals are generated and reducing the transmission of electrical signals by over excitable nerve cells. This action of Topamax tablets 50mg is thought to contribute to the blocking of pain signals, which reduces the occurrence of a migraine headache. Topamax tablets 50mg are not intended to treat a migraine attack but can control the number of migraine attacks if they happen regularly and frequently, to help you manage your daily life.

What are the side effects of Topamax?

The most commonly reported side effects when taking Topamax tablets 50mg usually relate to the dose you are taking and include: unusual tiredness, drowsiness, weakness, dizziness; decrease in appetite or weight loss, slowness of thought processes (bradyphrenia), tingling and numbness of hands and feet (paresthesia); headache; nausea, diarrhoea, constipation; memory impairment; double vision (diplopia); inability to sleep; speech disturbances; anxiety and depression;

When should Topamax not be used?

You should not use Topamax if you:

• are allergic to topiramate or any ingredients in Topamax tablets 50mg
• if you are pregnant or breastfeeding
• have or have had kidney stones
• have kidney disease or liver disease or glaucoma
• have a psychiatric disorder
• are taking medication that interact with Topamax, including: other epilepsy medicines like phenytoin or carbamazepine; digoxin for heart failure; CNS depressant medicines and alcohol; oral contraceptives; lithium and risperidone (for bipolar disorder and schizophrenia), the diuretic hydrochlorothiazide; metformin, pioglitazone, glibenclamide for diabetes; the anticonvulsant valproic acid
• are taking any medicine which slows your reactions, such as medicines to help you sleep or relieve pain, antidepressants, tranquillisers or antihistamines which can make you drowsy

What medications interact with Topamax?

Several medications interact with Topamax and should either not be taken while you are taking Topamax only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Topamax: any medicine which slows your reactions (CNS depressants), such as medicines to help you sleep or relieve pain, antidepressants, tranquillisers or antihistamines which can make you drowsy and the effects may be worse when combines with Topamax; the anticonvulsant valproic acid can cause metabolic disturbances
• Drugs that affect Topamax: other epilepsy medicines like phenytoin or carbamazepine; the diuretic hydrochlorothiazide
• Drugs that are affected by Topamax; digoxin for heart failure; oral contraceptives; lithium and risperidone (for bipolar disorder and schizophrenia); metformin, pioglitazone, glibenclamide for diabetes

How should Topamax be taken?

You should take your Topamax tablets 50mg with a glass of water, with or without food, once daily preferably at the end of the day. Your doctor will probably start you on a low dose and then increase your dose, which may be taken as 2 tablets morning and evening, depending on how well you respond, what you are being treated for and your doctor’s recommendation. You should take your Topamax tablets 50mg continually for as long as recommended by your doctor, which may be for several months or longer and you should not stop taking your tablets, you will probably discontinue treatment gradually.

How long should you take Topamax?

You should take your Topamax tablets 50mg continually for as long as recommended by your doctor, which may be for several months or longer.

Missed dose of Topamax

If you miss a dose of Topamax tablets 50mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Topamax be stored?

You should store your Topamax tablets 50mg in a cool, dry place at room temperature below 25°C.