Topirva 25mg Tablet 10pcs

Uses of Topirva 25mg Tablet

• Treatment of seizures in adults and children (above 6 years of age) alone
• Treat seizures in adults and children above 2 years of age along with other medicines
• Prevention of migraine headaches in adults

Side Effects of Topirva 25mg Tablet

• Common: Nausea, abdominal pain, dyspepsia, diarrhea, dry mouth, taste disturbance, weight loss, anorexia, paresthesia, headache, fatigue, dizziness, speech disorder, drowsiness, insomnia, impaired memory, anxiety, depression, visual disturbance.
• Less Common: Suicidal ideation, metabolic acidosis, alopecia.
• Rare: Leukopenia, thrombocytopenia, serious skin reactions.

How does Topirva 25mg Tablet work?

It controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.

Quick Suggestions:

• It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
• Keep yourself hydrated by drinking plenty of fluids throughout the day while taking Topiramate. This can reduce the risk of kidney stones.
• Monitor your weight during treatment with this medicine as it can cause weight gain.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.

Indication of Topirva 25mg Tablet

Epilepsy

• Monotherapy: For adults and children aged 6 years and above with newly diagnosed epilepsy experiencing generalized tonic-clonic seizures or partial seizures with or without secondary generalization.
• Adjunctive Therapy: For adults and children over 2 years who are inadequately controlled on conventional first-line antiepileptic drugs for partial seizures with or without secondary generalization, seizures associated with Lennox-Gastaut Syndrome, and primary generalized tonic-clonic seizures.

Migraine

• Prophylaxis: For adults experiencing three or more migraine attacks per month or frequent attacks that interfere with daily routine. Therapy should be reviewed every six months.

Pharmacology

• Seizures: These are caused by abnormal electrical discharges in the brain that lead to reduced alertness, abnormal sensations, and involuntary movements.
• Mechanism: Topiramate’s exact mechanism is not fully understood but involves actions on sodium channels, GABA receptors, and glutamate receptors, increasing inhibitory GABA activity and reducing excitatory glutamate activity to prevent seizures and migraines. It also blocks voltage-dependent sodium channels and inhibits certain carbonic anhydrase isozymes.

Dosage & Administration:

Epilepsy Monotherapy:

• Adults & Children (16+ years): Start at 25 mg nightly for 1 week, increasing by 25-50 mg/day at 1-2 week intervals. Initial target: 100 mg/day, maximum: 400 mg/day.
• Children (6-16 years): Start at 0.5-1 mg/kg nightly for 1 week, increasing by 0.5-1 mg/kg/day at 1-2 week intervals. Initial target: 3-6 mg/kg/day, maximum: 16 mg/kg/day.

Epilepsy Adjunctive Therapy:

• Adults & Children (16+ years): Effective dose: 200-400 mg/day in two doses. Maximum: 800 mg/day.
• Children (2-16 years): Recommended dose: 5-9 mg/kg/day in two doses. Start at 25 mg nightly, increasing by 1-3 mg/kg/day at 1-2 week intervals, maximum: 30 mg/kg/day.

Migraine Prophylaxis:

• Adults & Children (16+ years): Start at 25 mg nightly for 1 week, increasing by 25 mg/day at 1-week intervals. Target dose: 100 mg/day in two doses. Some benefit at 50 mg/day.
• Children: Not studied for migraine prevention under 16 years.

Overdose Effects

• Symptoms: Severe metabolic acidosis.
• Treatment: Gastric lavage, activated charcoal, supportive care, hemodialysis. Ensure the patient is well hydrated.

Interaction

• Antiepileptics: No significant effect on steady-state plasma concentrations except a possible increase in phenytoin levels.
• CNS Depressants: Use with caution with alcohol and other CNS depressants.
• Oral Contraceptives: May reduce efficacy, recommend preparations with ≥50 μg estrogen or non-hormonal contraception.
• Lithium: Monitor lithium levels as systemic exposure increases with higher doses of Topirva.
• HCTZ & Metformin: May affect serum potassium levels and metformin pharmacokinetics, respectively.
• Pioglitazone & Glibenclamide: Monitor blood sugar levels.
• Nephrolithiasis Risk: Avoid use with other nephrolithiasis-inducing agents.
• Valproic Acid: Can cause hyperammonemia; monitor ammonia levels.

Contraindications

Hypersensitivity to any components of Topirva.

Pregnancy & Lactation

• Pregnancy: Use only if the benefit outweighs the risk.
• Breastfeeding: Not recommended.

Precautions & Warnings

• Gradually withdraw to minimize seizure risk.
• It can cause CNS-related adverse events (e.g., drowsiness, visual disturbances).
• Avoid driving or operating machinery if affected.

Storage Conditions:

Store below 30°C, away from light and moisture. Keep out of reach of children.