Topiramate
- Atc Codes:N03AX11
- CAS Codes:97240-79-4
- PHARMGKB ID:97240-79-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Topamax, Topilex, Topiramat; Belgium: Topamax, Topiramate; Bulgaria: Epimaxan, Talopam, Topamax, Topirax; Cyprus: Topamax, Topiren; Czech Republic: Epimaxan, Erravia, Tidian, Topafis, Topamax, Topilept, Topilex, Topimark, Topiragis, Topiramat, Topiramate, Zidoxer; Denmark: Epitomax, Topamac, Topimax, Topiramat, Topiratore; Estonia: Epimaxan, Monotop, Topamax, Topilex, Topimark, Topiramate; Finland: Topimax, Topiramat; France: Epitomax, Topiramate; Germany: Epilania, Epimaxan, Topamac, Topamax, TopiCare, Topirafex, Topirafinelin, Topiragamma, Topiramat, Topiramed, Topirastad, Topira-Q; Greece: Letop, Pirantal, Topamac, Topepil, Topiramate, Topiref, Toramat; Hungary: Epilania, Epimaxan, Etopro, Leptam, Talopam, Topamax, Topepsil, Topilex, Topiramat, Topiramate, Toprazopan, Zidoxer; Ireland: Topamax, Topirama, Topiramate, Topit; Italy: Topamax, Topiramato; Latvia: Epimaxan, Monotop, Tidian, Topamax, Topilex, Topimark, Topiramat, Topiramate; Lithuania: Epimaxan, Monotop, Ropimate, Topamax, Topilex, Topimark, Topiramat, Topiramate; Malta: Topamax, Topiramate, Toramat; Netherlands: Epitomax, Erudan, Topamax, Topepsil, Topilept, Topiramaat, Topitex; Poland: Epilania, Epimaxan, Epiramat, Epitop, Epitoram, Erudan, Etopro, Monotop, Oritop, Ramatop, Symtopiram, Tidian, Tomalex, Topamax, Topigen, Topilek, Topimatil, Topimerck, Topiragis, Topiral, Topiramat, Topiramate, Topistad, Toramat, Zidoxer; Portugal: Olandic, Pirepil, Topamax, Topiramato; Romania: Epimaxan, Lusitrax, Tidian, Topamax, Topilex, Topiramat, Topran, Torlepta, Zidoxer; Slovakia: Epilania, Epimaxan, Erravia, Talopam, Tiramat, Topamax, Topepsil, Topilex, Topimark, Topiramat, Zidoxer; Slovenia: Letop, Topamax, Topiramat; Spain: Acomicil, Epilmax, Topamax, Topibrain, Topimylan, Topiramato; Sweden: Topamac, Topamax, Topimax, Topiramat, Topiratex, Topiratore; UK: Topamax, Topiramate.
North America
Canada: Topamax, Topiramate; USA: Topamax, Topiramate.
Latin America
Argentina: Neutop, Topamac, Topictal, Topiramato, Zinalow; Brazil: Topamax, Topiramato; Mexico: Nabian-K, Topamax.
Asia
Japan: Topina.
Drug combinations
Chemistry
Topiramate: C~12~H~21~NO~8~S. Mw: 339.36. (1) β-D-Fructopyranose, 2,3:4,5-bis-O-(1-methylethylidene)-, sulfamate; (2) 2,3:4,5-di-O-isopropylidene-β-D-fructopyranose sulfamate. CAS-97240-79-4 (1987).
Pharmacologic Category
Anticonvulsants, Miscellaneous. (ATC-Code: N03AX11).
Mechanism of action
Blocks neuronal voltage-dependent sodium channels, enhances GABA(A) activity, antagonizes AMPA/kainate glutamate receptors, and weakly inhibits carbonic anhydrase.
Therapeutic use
Monotherapy or adjunctive therapy for partial onset seizures and primary generalized tonic-clonic seizures. Adjunctive treatment of seizures associated with Lennox-Gastaut syndrome. Prophylaxis of migraine headache.
Pregnancy and lactiation implications
Teratogenic in animal studies. However, limited information in pregnant women. Use only if benefit to mother outweighs risk to fetus. Based on limited data, topiramate found to cross placenta. Reports of hypospadias following in vitro exposure to topiramate. Enters breast milk (not recommended in nursing women).
Unlabeled use
Infantile spasms, neuropathic pain, cluster headache.
Contraindications
Hypersensitivity to topiramate or any component of the formulation.
Warnings and precautions
Cognitive dysfunction, psychiatric disturbances (mood disorders), and sedation (somnolence or fatigue) may occur with use. May also cause paresthesia, dizziness, and ataxia. Associated with acute myopia and secondary angle-closure glaucoma in adults and children. Discontinue in acute onset of decreased visual acuity or ocular pain. Hyperthermia may be associated with severe oligohydrosis and hyperthermia, most frequently in children. May decrease serum bicarbonate concentrations, due to inhibition of carbonic anhydrase and increased renal bicarbonate loss. Treatment-emergent metabolic acidosis is less common, however, risk may be increased in predisposing condition (renal, respiratory and/or hepatic impairment), ketogenic diet, or concurrent treatment with other drugs which may cause acidosis. Metabolic acidosis may occur. Topiramate exhibits carbonic anhydrase properties and risk of kidney stones is about 2-4 times that of untreated population. Kidney stones reported in children and adults. Use with caution in hepatic and renal impairment. Effects with other sedative drugs or ethanol may be potentiated. Hyperammonemia with or without encephalopathy may occur (risk may be increased in patients with inborn errors of metabolism or decreased hepatic mitochondrial activity). Anticonvulsants should not be discontinued abruptly.