What Factors Affect a Sufficient Topiramate Dose?

Topiramate is a natural monosaccharide dextrose fructose sulfide. In vitro studies have confirmed that the mechanism of this product's antiepileptic effect may be: selectively block voltage-dependent sodium channels to limit continuous repeated discharges; act on -aminobutyric acid receptors and enhance -aminobutyric acid Nerve inhibitory effect; Act on glutamate receptors, antagonize kainic acid / AMPA glutamate receptors, and reduce glutamate-mediated nerve excitatory effects.

Basic Information

Drug Name

Topiramate

Alias

Topamax

Main indications

Effective for all types of seizures

Drug type

It is mainly used as an adjuvant treatment for other antiepileptic drugs. It is used for simple partial seizures, complex partial seizures and general tonic clonic seizures. It is especially effective for Lennox-Gastaut syndrome and West syndrome (baby spasm). The long-term effect of this product is good, no obvious tolerance, large doses can be used as a single drug treatment.

Adults, orally: Start 25 mg / day, and increase once a week after 1 week, each time increasing by 25-50 mg to 200-400 mg / day, divided into two doses; the maximum dose is 1600 mg / day.

Mainly adverse reactions of the central nervous system, such as dizziness, fatigue, diplopia, nystagmus, drowsiness, emotional instability, depression, ataxia, loss of appetite, aphasia, attention disorder, and blurred consciousness. The duration generally does not exceed 4 months. Rarely anxiety and insomnia. The occurrence of adverse reactions has nothing to do with the dosage. Has had adverse reactions such as weight loss, cognitive impairment, sweat closure and high fever, metabolic acidosis, hyperchloremia, acute eye symptoms (hypovision, acute myopia, angle-closure glaucoma, etc.) and allergic rash Report. Because this product may cause cognitive impairment, it should be used with caution in school-age children and adolescents.

1. All antiepileptic drugs, including this medicine, should be gradually reduced to prevent recurrence or exacerbation.

2. When taking topiramate, you should maintain sufficient water intake. Adequate water intake can reduce the risk of kidney stones. Adequate drinking water before or during exercise, or in high temperature environments, can reduce fever-related adverse events.

3. Antiepileptic drugs, including this product, may increase the risk of suicidal ideation and behavior in any indication for patients taking such drugs.

4. Patients with impaired liver function should use this product with caution.

5. Animal experiments show that this product has reproductive toxicity. Adequate, well-controlled studies of this product have not been performed in pregnant women. Use this product during pregnancy only if the potential benefits outweigh the risks to the fetus.

Those who are allergic to this product are prohibited.

1. Topiramate combined with other antiepileptic drugs, except in a very small number of patients found that topiramate combined with phenytoin can lead to increased plasma concentrations of phenytoin, topiramate has no effect on the steady-state plasma concentrations of other drugs.

2. Phenytoin and carbamazepine can reduce the plasma concentration of topiramate. Addition or discontinuation of phenytoin or carbamazepine during topiramate treatment may require adjustment of the topiramate dose.

Note: The above content is only for introduction, the drug use must be carried out by a regular hospital under the guidance of a doctor.