Download Antiepileptic Medication: Topamax (topiramate)

Antiepileptic Medication:
Topamax (topiramate)
General Information Topamax
is one of the newer antiepileptic
medications. It was developed in the 1980s.
It is used for the treatment of partial seizures
with or without secondary generalizations,
primarily generalized seizures, drop attacks in
Lennox Gestaut, and West’s syndrome.
•
Drug specific:
▬ Weight loss & lack of appetite
▬ Sudden eye pain with a history
of glaucoma.
▬ Numbness & tingling of
extremities
▬ Kidney stones
How does it work?
Topamax is a potent antiepileptic drug that
works in multiple ways to prevent seizures.
1) It helps to block sodium channels.
2) It decreases the amount of excitatory
chemicals in the brain
3) It increases the amount of inhibitory
chemicals in the brain.
•
Dose-related:
▬ Tiredness
▬ Difficulty concentrating
▬ Dizziness
▬ Memory difficulties
▬ Mood changes
•
Initiation: You may notice some
dose-related side effects during the
first couple of weeks of treatment.
Your body should get used to the
medication if you give it a chance.
Available forms
It is available in a generic as well as brand
name in the following doses: 25, 50, 100, &
200 mg. tablets & 15 & 25 mg. sprinkles.
You need to report any signs of drug
specific reactions to the doctor
immediately: especially eye pain. You
may be asked to stop the medication.
Interactions
• Grapefruit
Drug basics
After you take your dose, it takes about 2-4
hours for the drug to have a maximum effect.
You might be more aware of dose related side
effects at this time if you have them. It takes
19-25 hours for half of the Topamax to leave
your body. This allows you to take the
medication twice a day. Less than 20% of the
drug binds to proteins. This portion of the
drug is not active. It is metabolized in the
liver and excreted in the urine.
Side Effects
There are 3 different types of side effects:
• Some anticonvulsants may decrease
Topamax levels
• Oral contraceptives and Coumadin are
metabolized faster when taking
Topamax.
Lab Monitoring
We are able to check a Topamax level.
However, it is not necessary to perform on a
regular basis. It does take about 4 days to get
your results.
Final Note
If you are having difficulty with you
medication, please notify your doctor. It may
be possible to adjust your dose.
Created by Diana Murray RN, CNS, MS, CNRN & Mark Yerby MD, MPH
Portland, Oregon
1/13/2010