Topamax general information
What is Topamax used for?
Our brain is the control centre for our whole body. A malfunction anywhere in the central nervous system, which includes the brain, spinal cord, and nerves, can cause neurological disorders that include epilepsy and migraine. Topamax tablets 25mg are used to treat epilepsy in adults and children and to prevent migraine in adults.
Epilepsy is a neurological disorder that causes seizures, also known as convulsions or fits. These seizures are unpredictable and recurrent, and they vary in frequency and range from mild to severe.
An epileptic seizure is caused by abnormal bursts of electrical activity in the brain resulting in uncontrolled muscular spasm. You may experience other symptoms, including emotional and behaviour changes, also strange sensations like feelings of temperature fluctuations or intestinal movements.
Seizure type depends on where the abnormal brain activity starts, and how much of the brain is involved. A generalised seizure affects both sides of the brain at the same time, which in its most severe form, is called a tonic-clonic seizure (previously called a grand-mal). This causes loss of awareness and uncontrollable jerking and twitching movements. A focal seizure (previously called partial) begins in one side of the brain, and awareness can remain. However, a focal seizure can spread to both sides and become a tonic-clonic seizure. Causes are often unknown but may be due to genetic changes in the brain, related to a head injury, diseases like Alzheimer’s, a brain tumour, and infection like meningitis. Specific triggers have also been identified, such as hormonal changes, flickering lights, high fever, and some foods.
A migraine is a neurological disorder that causes an intense, throbbing, and painful headache, usually on one side of the head. A migraine headache is generally accompanied by other symptoms, including nausea, vomiting, and extreme sensitivity to light. An aura can be the first sign of a migraine attack and includes visual disturbances like zig-zag lines and blurring. Other signals that a migraine attack is imminent include changes in the sense of smell, food cravings, mood changes, repetitive yawning, dizziness, tingling and numbness, and fatigue.
A migraine attack is thought to be triggered by the abnormal release of chemicals in the brain that causes inflammation, pain, and extreme widening (dilation) of brain blood vessels. These dilated blood vessels are thought to cause inflammation in the surrounding tissues and irritate the nearby sensory trigeminal nerves. Activation of trigeminal nerves induces pain and other symptoms of a migraine.
Genetics is known to play a role, and you may have a family member who also suffers from migraines. Various other factors may be migraine triggers, including stress, hunger, hormonal changes, some foods like cheese or chocolate, caffein-containing drinks like coffee, and alcohol, amongst others.
Topamax tablets 25mg are used to prevent (prophylaxis) migraines when they happen regularly and seriously affect the quality of life and normal daily activities. They are not used to treat severe acute migraine attack that comes on suddenly.
How does Topamax work?
Topamax tablets 25mg contain topiramate, an anticonvulsant that is used to treat epilepsy to control seizures and is also used as a prophylactic treatment for migraine.
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. These signals travel to all parts of the body transmitted by chemical messengers called neurotransmitters. Signal transmission usually happens in an orderly fashion to control all our actions and thought processes. Epileptic seizures are caused by abnormal electrical activity in the brain, with uncontrolled, rapid, and repetitive electrical signals being sent continually to various parts of the body.
Neurotransmitters are chemical messengers that allow nerve cells to communicate and can be either excitatory or inhibitory. Excitatory neurotransmitters stimulate the transmission of the electrical signal. Inhibitory neurotransmitters block transmission and therefore, have a calming effect on the nervous system. Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter and glutamate is the main excitatory neurotransmitter. A balance between excitatory and calming neurotransmitters is essential for the brain to function normally, and an imbalance is thought to be involved in epilepsy.
Topiramate in Topamax tablets 25mg acts directly on the brain cells to reduce the rate at which electrical signals are generated. It works by blocking the sodium channels that allow positive sodium ions to flow in and out of nerve cells. Topiramate also enhances the activity of GABA and inhibits the activity of glutamate. These actions of topiramate in Topamax tablets 25mg reduce the ability of nerve cells to send out continuous signals, which has a calming effect on brain electrical activity, to control seizures in epilepsy.
Migraine is thought to be triggered by lack of serotonin, a neurotransmitter that is involved in the control of mood, pain sensation, sexual behaviour and sleep, as well as constriction of blood vessels. Low levels of serotonin cause blood vessels in the head to dilate and widen, which initiates migraine attack. Topiramate in Topamax tablets 25mg works by balancing abnormal neurotransmitter levels, including serotonin, which helps prevent or reduce the frequency of migraine attack.
What does Topamax contain?
Topamax tablets 25mg contain the active ingredient topiramate, an anticonvulsant used to treat epilepsy to control seizures and also used as a prophylactic treatment for migraine. It also contains lactose, pregelatinised maize starch, purified water, carnauba wax, microcrystalline cellulose, sodium starch glycollate, magnesium stearate, titanium dioxide, Hypromellose, lauromacrogol 400, polysorbate 80.
What are the side effects of Topamax?
Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking Topamax tablets 25mg, but others are not so common, and you should discuss any problems or concerns with your primary care physician.
Common side effects when taking Topamax include tiredness, lethargy, drowsiness, weakness, dizziness, decrease in appetite or weight loss, slowness of thought processes (bradyphrenia), tingling and numbness of hands and feet (paraesthesia), headache, nausea, diarrhoea, constipation, memory impairment, blurred vision, double vision (diplopia), eye discomfort, dry eyes, sleep problems, speech disturbances, anxiety, depression, vertigo, tinnitus, difficulty breathing (dyspnoea), nasal congestion, skin rash, itching, muscle and joint pain, kidney stones (nephrolithiasis), discomfort urinating (dysuria).
When should Topamax not be used?
Have a talk with your primary healthcare physician before taking Topamax tablets 25mg so that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for Topamax you should consider the following before taking Topamax:
- Have you ever had an unusual reaction or an allergy when taking Topamax?
- Are you pregnant or breastfeeding?
- Do you have any problems with your kidneys or your liver?
- Have you ever had kidney stones?
- Do you have a mental illness?
- Do you have glaucoma?
- Are you taking any medications that slow 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?
Some medicines interact with Topamax tablets 25mg and may affect the way it works, or are affected by Topamax or increase side effects; you should discuss possible interactions with your primary care physician. These may include other epilepsy medicines like phenytoin, carbamazepine and valproic acid digoxin for heart failure, CNS depressant medicines and alcohol, oral contraceptives, lithium and risperidone for bipolar disorder and schizophrenia, the diuretic hydrochlorothiazide for high blood pressure, metformin, pioglitazone and glibenclamide for diabetes, the anticoagulant warfarin, oral contraceptives.
If other medications may interact with Topamax, your doctor will discuss these with you.
How should Topamax be taken and for how long?
You should take your Topamax tablets 25mg swallowed whole 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 two tablets morning and evening. The dose you take will depend on how well you respond, what you are being treated for and your doctor’s recommendation. You should take your Topiramate Actavis 25mg 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.
Missed dose of Topamax
If you miss a dose of Topamax tablets 25mg 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 25mg below 25°C in a cool dry place.