Generic Topamax i.e. Topiramate is an oral drug that is used to prevent the seizures of epilepsy. It is an anti-epileptic or anti-seizure drug. It is used primarily among patients who are not controlled by other anti-epileptic drugs. About 1 in 4 Americans diagnosed with epilepsy has seizures that resist treatment with other anti-epileptic drugs. Topiramate also prevents the migraine headaches. Seizures are due to the abnormal activity firing of nerves in the brain and the abnormal activity spreads to smaller or larger portions of the brain.

Although topiramates exact mechanism of action is unknown scientific studies suggest that it may alter neurotransmitters within the brain. Neurotransmitters are chemicals that nerves manufacture and use to communicate with other nearby nerves. By altering the production or action of the neurotransmitters topiramate may suppress the abnormal activity of the nerves in the brain that cause the seizures or may prevent the abnormal activity from spreading to other nerves. Other studies suggest that topiramate may suppress the nerves directly i.e. not by altering neurotransmitters and make them less likely to fire.

The FDA approved topiramate as a tablet in 1997. The Sprinkle Capsules were approved in October 1998.

However, before taking Topiramate i.e. Topamax medication, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient and read it carefully. Talk to your doctor about all the possible risks of taking Topamax medication. However, Topamax may also be used for purposes other than those listed in this medication guide. Hence, for more information, consult your doctor and your medical pharmacist.

Follow the directions given by the doctor exactly for the usage of the Topamax i.e. Topiramate medication and also read the prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Most commonly topiramate is started in low doses 25 or 50 mg per day and then increased slowly under a doctor’s supervision by 25 to 50 mg per week until an effective daily dose is reached. This slow approach to treatment reduces side effects.

Although the usual adult dose is 200 mg twice daily some adult patients may begin to see a clinical response at 200 mg per day. Some patients need doses higher than 200 mg daily. In children the usual dose is 2.5 to 4.5 mg/kg twice daily.

Patients should maintain an adequate fluid intake in order to minimize the risk of kidney stones.

If you wish to use the medication for your children, please contact your pediatrician for the dosage. However, in children the starting dose is up to 25 mg 1 to 3 mg/kg/day taken nightly for the first week. The dose is then increased at 1 or 2 week intervals by 1 to 3 mg/kg/day.

If you notice any of the symptoms, which seem severe or persistent to you, please contact your doctor immediately. However, your doctor may need to monitor you carefully for side effects and alter the doses if necessary.

In adults the most common side effects of topiramate are tiredness, dizziness, coordination problems, speech problems, changes in vision or double vision, difficulty with memory and sensory distortion.

In children the most common side effects are drowsiness, tiredness, loss of appetite, nervousness, difficulty with concentration/attention, weight decrease, aggressive reaction and difficulty with memory.

Since topiramate was approved there have been 23 cases reported as of 8-17-01 of a sudden onset of vision and eye problems. Symptoms have typically occurred within the first month of therapy with patients reporting an acute onset of decreased vision and/or eye pain. Eye examination revealed myopia i.e. nearsightedness, redness, decreased depth of the anterior chamber of the eye and elevated ocular pressure with or without dilation of the pupils. Fluid accumulation within the eye may displace the lens and iris anteriorly causing secondary angle closure glaucoma. If patients develop this syndrome the treatment is to discontinue topiramate as rapidly as possible according to the judgment of the treating physician.

Inform your doctor if you experience any of these side effects or some new side effects occur which appear too bothersome to you.

Inform your doctor if you are allergic to the formulation of this medication or any other medication in any other form and also inform your doctor about any other medication you may be taking in any other form, as they may affect the way your medicine works.

The following medications when taken with topiramate increase the risk of kidney stones: acetazolamide i.e. Diamox, dorzolamide i.e. Trusopt, methazolamide i.e. Neptazane, dichlorphenamide i.e. Daranide.

Carbamazepine Tegretol and phenytoin Dilantin markedly decrease the amount of topiramate in the body by increasing its elimination from the body. As a result topiramate may lose effectiveness unless doses are increased. Moreover, Topiramate may decrease the amount of estrogen in the body in women taking oral contraceptives possibly increasing the chances of unwanted pregnancy.

Patients with seizure disorders taking anticonvulsant medications including topiramate may develop nerve toxicity from a chemical 4-O-methylpyridoxine found as a contaminant in some ginkgo preparations.

Moreover, Topamax i.e. Topiramate may also interact with some kind of foods, varied medications, herbal products, nutritional supplements, vitamins, other OTC medicines etc. Acquire more information about the interactions of the Topamax medication from your doctor and the medical pharmacists.

In case of overdose call your local poison control center at 1-800-222-1222.
If the suffering patient has collapsed or is not breathing call local emergency services at 911. Canadian residents should call their local poison control center directly.

Do not allow any other person to use your medication without getting doctor’s prescription themselves and also avoid using this medicine for other health conditions on your own. Keep the medicine away from the children and pets.

Also inform your doctor, if you are pregnant or are breast feeding. If you conceive during the course, inform your doctor immediately. Do not share your medicines with anyone, even if they have the same symptoms, for it may harm them. Do not begin, increase, decrease, or stop using this medicine on your own.

Remember, it is very important to keep regular appointments with your doctor to study the way your body is responding to the course. And if you are going to have a surgery, tell your health care professional that you are taking Topamax medication.

Inform your doctor if you have or have ever had: kidney disease, kidney stones, lung disease, liver disease, cirrhosis, heart disease, diabetes, low or high blood pressure, diarrhea, metabolic acidosis, glaucoma or any other severe disease etc. Also inform, if you drink alcoholic beverages or smoke or if you are following a ketogenic diet.

And in case, if you wish to use the medicine in children, please contact your pediatrician for sure before its use.

If you missed the dose, do take the medicine immediately provided that there is ample of time in between the next dose. However, if it is almost time for the next dose skip the missed dose and continue your regular dosing schedule. Never double your doses to cope up with the missed. And in case, if you miss your one or two consecutive doses consult to your doctor or physician for guidance and continue further.

Seizures may be classified as either partial if they involve only a small portion of the brain or generalized if they involve more of the brain. Topiramate is used in combination with other anti-seizure drugs among adults and children aged 2-16 years with partial seizures or generalized tonic-clonic seizures in which there is prolonged contraction of the muscles of the body that causes rigidity as well as jerking motions. Topiramate sprinkle capsules are approved for treatment without other drugs in patients 10 years of age and older.

Topiramate also is used in patients two years of age and older with seizures associated with the Lennox-Gastaut Syndrome a severe form of epilepsy which accounts for up to 10 percent of all cases of childhood epilepsy. Children with Lennox-Gastaut Syndrome experience delays in their development and up to dozens of different mixed types of seizures a day. The most common types of seizures in this syndrome are tonic i.e. stiffening of the body, with the eyes rolling upwards, dilation of the pupils and shallow and irregular breathing, atonic i.e. brief loss of muscle tone and consciousness, causing abrupt falls, myoclonic i.e. sudden muscle jerks and absence staring spells.

Topiramate also is approved for the prevention of migraine headaches in adults.

However, it may also be used to treat some other medical conditions which may be determined by your doctor accordingly and consult a pediatrician for the use of this medication in children.

The Topamax i.e. Topiramate medication may be prescribed for other uses also, so ask your doctor or pharmacist for more information about the Topamax i.e. Topiramate medication.

Generic Topamax i.e. Topiramate tablets should be stored at room temperature 59-86°F and 15-30°C in a cool and dry place. And Sprinkle capsules should be stored at or below 77 ° F 25 °C. Keep the medicine in the container, it came in and always keep it tightly closed. Check Expiry date without fail. Keep all medicines away from women, newborns, children and pets. Do not freeze in any case. Also, keep it away from heat, dampness and direct light. Heat or moisture may cause the medicine to break down. When the medicine is not in use or outdated it should be discarded. Take help of your pharmacist in disposing this medicine properly. In any case, do not store the Topamax tablets in the bathroom.

Following precautions must be taken during consuming generic Topamax i.e. Topiramate:

1. Inform your doctor if you have or have ever had: kidney disease, kidney stones, lung disease, liver disease, cirrhosis, heart disease, diabetes, low or high blood pressure, diarrhea, metabolic acidosis, glaucoma or any other severe disease etc. Also inform, if you drink alcoholic beverages or smoke or if you are following a ketogenic diet.

2. Also acknowledge your doctor if you need to undergo any kind of surgery, including dental surgery or need an x-ray procedure that uses contrast agents. So, inform your doctors immediately about it, so that the doctor can decide whether to continue taking Topamax medication or stop it during the surgery.

3. Let the doctor also know, if you are in-taking or are planning to take any prescribed or non prescribed medicines, health supplements or any other OTC medications, vitamins etc. Be sure to mention any of the following: cyclosporine i.e. Neoral, Sandimmune, and digoxin i.e. Lanoxin and ketoconazole i.e. Nizoral. This is because, your doctor may need to change the doses of your medications or monitor you carefully for side effects.

4. Do not use the Topamax i.e. Topiramate medication, if you have any kind of allergy to it or to any ingredients of it and tell your doctor or pharmacist about the allergy and get treated. Also inform if you are allergic to Topiramate, lansoprazole i.e. Prevacid, omeprazole i.e. Prilosec, pantoprazole i.e. Protonix, or any other medications.

5. Tell your doctor if you are pregnant or breast feeding before taking Topamax medication. Hence also, inform your doctor immediately when you plan to conceive, or become pregnant during the course as this drug should be used only when clearly needed during pregnancy.

6. Do not share the drug with others unless they are prescribed by the doctor themselves. And if your symptoms of side effects do not improve in few weeks or if they become worse and bothersome, check these conditions immediately with your doctor.

7. Please, use the Topamax medicine in the prescribed amount and do not overdose it or use it for the longer period of time. Do not discontinue on your own and consult your doctor before doing so to avoid further problems.

8. Regularly, keep your appointments with your doctor and keep an eye on the progress or side effects that has been noticed during the complete course.

9. Also, avoid alcohol and alcohol containing beverages during the complete.

10. For more information, contact your doctor and your pharmacists and also discuss the risks and benefits of the generic Topamax.