Topirva 50

Tablet
Generics: Topiramate 50mg
Category : Prescription Medicines Availability : In Stock Company : Incepta Pharmaceuticals Ltd
Price

৳100.00

Required Prescription

Indications Topiramate is used as a monotherapy in adults and children aged 6 and up who have newly diagnosed epilepsy and are experiencing generalised tonic-clonic seizures or partial seizures with or without secondary generalised seizures.Topiramate is used as an additional therapy for partial seizures with or without secondary generalisation, seizures associated with Lennox Gastaut Syndrome, and primary generalised tonic-clonic seizures in adults and children over the age of two. Migraine: Topiramate is prescribed for the prevention of migraine headaches in adults. Adults who have three or more migraine episodes per month, or who have frequent migraine attacks that significantly disrupt the patient's normal routine, may benefit from prophylactic migraine medication. Every six months, continue therapy should be reassessed.

Topirva 50

Pharmacology

A seizure is a brain electrical discharge that is aberrant and uncontrolled. Reduced alertness, strange feelings, and focused involuntary movements or convulsions are all symptoms of a brief disruption in brain activity. Seizures come in a variety of forms, the most frequent of which are tonic-clonic seizures and partial onset seizures.The specific mechanisms through which topiramate exerts its pharmacological effects on seizures and migraines are still unknown. However, several features of this medicine are likely to have a role in its therapeutic effects. Voltage-dependent sodium channels, GABA receptors, and glutamate receptors have all been found to be affected by topiramate.

 

Topiramate lowers glutamate activity at both AMPA and kainate receptors while stimulating GABA-A receptor activity at non-benzodiazepine receptor locations in the brain. GABA-A receptors normally regulate neuronal activity while glutaminergic receptors stimulate it. Topiramate reduces neuronal excitability by enhancing GABA activity and reducing glutamate activity, avoiding seizures and migraines.

 

Additionally, it inhibits seizure activity by inhibiting voltage-dependent sodium channels. Topiramate has been demonstrated to block a variety of carbonic anhydrase isozymes, but the clinical implications of this has yet to be determined.

 

 

 

Dosage & Administration

Epilepsy: Monotherapy:

 

Adults and children over 16 years: Titration should begin at 25 mg nightly for 1 week. The dosage should then be increased at 1- or 2-week intervals by increments of 25 or 59 mg/day, administered in two divided doses. The recommended initial target dose for topiramate monotherapy in adults with newly diagnosed epilepsy is 100 mg/day and the maximum recommended daily dose is 400 mg.

Children aged 6-16 years: Treatment of children aged 6 years and above should begin at 0.5 to 1 mg/kg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 0.5 to 1 mg/kg/day, administered in two divided doses. The recommended initial target dose range for topiramate monotherapy in children with newly diagnosed epilepsy aged 6 years and above is 3 to 6 mg/kg/day. Higher doses have been tolerated and rarely doses up to 16 mg/kg/day have been given.

Epilepsy: Adjunctive therapy:

 

Adults and children over 16 years: The minimal effective dose as adjunctive therapy is 200 mg per day. The usual total daily dose is 200 mg to 400 mg in two divided doses. Some patients may require doses up to 800 mg per day, which is the maximum recommended dose.

Children aged 2-16 years: The recommended total daily dose of Topiramate as adjunctive therapy is approximately 5 to 9 mg/kg/day in two divided doses. Titration should begin at 25 mg nightly for the first week. The dosage should then be increased at 1- or 2-week intervals by increments of 1 to 3 mg/kg/day (administered in two divided doses), to achieve optimal clinical response. Dose titration should be guided by clinical outcome. Daily doses up to 30 mg/kg/day have been studied and were generally well tolerated.

Migraine:

 

Adults and children over 16 years: Titration should begin at 25 mg nightly for 1-week. The dosage should then be increased in increments of 25 mg/day administered at 1-week intervals. The recommended total daily dose of topiramate as treatment for the prophylaxis of migraine headache is 100 mg/day administered in two divided doses. Some patients may experience a benefit at a total daily dose of 50 mg/day.

Children: Topiramate in migraine prophylaxis has not been studied in children under 16 years.

 

 

Interaction

Topiramate has no clinically significant effect on the steady-state plasma concentrations of other antiepileptic drugs (phenytoin, carbamazepine, valproic acid, phenobarbitai, primidone), except in some patients, where the addition of topiramate to phenytoin may result in an increase in phenytoin plasma concentrations.

 

When used with alcohol or other CNS depressants, topiramate should be used with caution.

 

Topiramate significantly improved plasma clearance of the oestrogenic component in an interaction trial with a combined oral contraceptive. As a result, patients should get a preparation containing at least 50 g of oestrogen or utilize an alternative non-hormonal method of contraception, keeping in mind the potential risk of teratogenicity.

 

Lithium pharmacokinetics were unaltered in patients with bipolar illness treated with Topiramate at dosages of 200 mg/day; however, there was an increase in systemic exposure (26 percent for AUC) following Topiramate doses of up to 600 mg/day. When Topiramate is used with it, lithium levels should be checked.

 

Hydrochlorothiazide (HCTZ): The concurrent dosing of Topiramate had no effect on the steady-state pharmacokinetics of HCTZ. Clinical test data showed that Topiramate or HCTZ administration resulted in a drop in serum potassium, which was even larger when HCTZ and Topiramate were given together.

 

Topiramate had no effect on the tmax of metformin. The clinical importance of topiramate's influence on metformin pharmacokinetics is unknown. Topiramate's oral plasma clearance appears to be lowered when combined with metformin. The clinical importance of metformin's influence on topiramate pharmacokinetics is unknown. When topiramate is introduced or removed from metformin-treated individuals.

 

 

 

Contraindications

Hypersensitivity to any of the product's ingredients.

 

 

 

Side Effects

Topiramate had no effect on the tmax of metformin. The clinical importance of topiramate's influence on metformin pharmacokinetics is unknown. Topiramate's oral plasma clearance appears to be lowered when combined with metformin. The clinical importance of metformin's influence on topiramate pharmacokinetics is unknown. When topiramate is introduced or removed from metformin-treated individuals.

 

 

 

Pregnancy & Lactation

Topiramate should not be used during pregnancy unless the possible benefit outweighs the potential harm to the fetus, according to the doctor. Topiramate should not be taken when nursing.

 

 

 

Precautions & Warnings

Antiepileptic medicines, such as topiramate, should be carefully tapered off in individuals with or without a history of seizures or epilepsy to reduce the risk of seizures or increased seizure frequency. Topiramate has the potential to cause central nervous system side effects and may be more sedative than other antiepileptic medications.Drowsiness is a possibility. There have also been reports of blurred vision and visual abnormalities. Patients should be informed about these risks and advised that if they are affected, they should not drive, operate machinery, or engage in activities that could put themselves or others in danger.

 

 

 

Therapeutic Class

Adjunct anti-epileptic drugs

 

 

 

Storage Conditions

Keep the temperature below 30°C and away from light and moisture. Keep out of children's reach.

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Topiramate 50mg
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