토피라메이트

용도

• Automatisms (running fits) and focal seizure activity
• Alternative second line anticonvulsant
• Alternative treatment for refractory generalized and focal seizures
• Seizures (Initial dose)
• Seizures
• Refractory epilepsy

투여 방법

가능한 부작용

• GI distress (dogs)
• Inappetence (dogs, cats)
• Irritability (dogs)
• Sedation/Lethargy (cats, dogs)
• Ataxia (dogs)
• Somnolence (humans)
• Dizziness (humans)
• Acute myopia with secondary angle closure glaucoma (rare, humans)
• Calcium phosphate renal calculi (humans)
• Sedation
• Ataxia
• Anorexia
• Weight loss
• Gastrointestinal upset

주의사항 및 금기

• Hypersensitivity to topiramate
• Known hypersensitivity to topiramate
• Use with caution in patients with impaired hepatic or renal function. Topiramate can cause a hyperchloremic metabolic acidosis and reduce citrate excretion in the urine, increasing urine pH and leading to calcium phosphate renal calculi. It is an FDA Category C drug for pregnancy (teratogenic effects noted in mice and rats) and enters maternal milk; use with caution in nursing patients.

약물 상호작용

• Amitriptyline: Topiramate may increase amitriptyline levels
• Carbonic Anhydrase Inhibitors (acetazolamide, dichlorphenamide): Concomitant use may increase the risk of renal stone formation
• CNS Depressants: May exacerbate the adverse effects of topiramate
• Lamotrigine: May increase topiramate levels
• Phenytoin: May decrease topiramate levels; phenytoin levels may increase
• Valproic Acid: May decrease topiramate and VPA levels
• Phenobarbital: May increase clearance and decrease plasma concentrations of topiramate

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