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Topiramate Fact Sheet

This information is not a replacement for full discussion of risks and benefits with you doctor.

Other Names: Topamax

Principal Uses: Topiramate used to treat certain kinds of seizures and it has also been used as a mood stabiliser, although its efficacy as a mood stabiliser is still being questioned. Also used to treat migraine.

Cost Special Authority required for subsidy. Topiramate costs about $60 for 60 of the 25mg tablets ( ie; about a $1 per 25mg tablet)

Dose: It is recommended that therapy should be initiated at a low dose followed by slow titration to an effective dose. Dose titration should be guided by clinical outcome. The usual target dose is between 100 mg/day to 500 mg/day. The dose also depends on whether the topiramate is been used alone (monotherapy) or in combination with another anti convulsant (add on, or polytherapy).

How it works: The precise mechanism of how topiramate works is unknown. It is thought to affect the receptor sensitivity of two important neurotransmitters, GABA and Glutamate.

Possible Side Effects:

These include the following: abnormal skin sensations; agitation or aggression; gastrointestinal disturbances; breast tenderness; clumsiness; confusion; decreased hearing; decreased sweating; dizziness; drowsiness; fatigue; flu-like symptoms; hot flushes; infection; itching; menstrual disorder; mood changes; anxiety; runny nose; saliva increased; sex drive decreased; sinus swelling;strange taste; sore throat; thinking problems; thirst; tremor.

Alcohol and certain other medicines (eg, sedatives, anti psychotic medication) may increase the risk of unfavourable reactions while taking Topiramate.

Sweating may be reduced by Topiramate. The risk of this side effect is greater in hot weather and/or during vigorous exercise.

Topiramate may decrease the effectiveness of birth control pills. Topiramate should be used cautiously with Lithium, because of its effects on renal function, and will require the close monitoring of the lithium levels.

Use in Pregnancy: Category C
Animal studies suggest it may possibly cause fetal abnormalities but there are no well controlled studies on humans.

Use in Breast Feeding: Category L3
There are no controlled studies of Topiramate in breast feeding. However one study suggests that it is excreted into breast milk in significant concentrations and negative effects on the infant are therefore possible. It is therefore not recommended to breast feed while taking this medication.

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