Topiramate description, usages, side effects, indications, overdosage, supplying and lots more!

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Topiramate

REMEDYREPACK INC.


FULL PRESCRIBING INFORMATION: CONTENTS*




FULL PRESCRIBING INFORMATION

TOPIRAMATE DESCRIPTION



Topiramate



CLINICAL PHARMACOLOGY

Mechanism of Action


PHARMACODYNAMICS



PHARMACOKINETICS






Metabolism and Excretion


Pharmacokinetic Interactions
Drug Interactions

Antiepileptic Drugs


USE IN SPECIFIC POPULATIONS

Renal Impairment
PRECAUTIONS: Adjustment of Dose in Renal FailureDOSAGE AND ADMINISTRATION

Hemodialysis
DOSAGE AND ADMINISTRATION

Hepatic Impairment


Age, Gender, and Race



Pediatric Pharmacokinetics



CLINICAL STUDIES



Epilepsy

Monotherapy Controlled Trial



Topiramate

Adjunctive Therapy Controlled Trials in Adult Patients with Partial Onset Seizures




Adjunctive Therapy Controlled Trial in Pediatric Patients Ages 2 to 16 Years with Partial Onset Seizures




Adjunctive Therapy Controlled Trial in Patients with Primary Generalized Tonic-Clonic Seizures




Adjunctive Therapy Controlled Trial in Patients With Lennox-Gastaut Syndrome


*
*Target Topiramate Dosage (mg/day)ProtocolStabilization DosePlacebo2004006008001000YDN42424041--Mean Dose5.9200390556--Median Dose6200400600--YEN44--404540Mean Dose9.7--544739796Median Dose10--6008001000Y1N23-19---Mean Dose3.8-395---Median Dose4-400---Y2N30--28--Mean Dose5.7--522--Median Dose6--600--Y3N28---25-Mean Dose7.9---568-Median Dose8---600-119N90157----Mean Dose8200----Median Dose8200----In all add-on trials, the reduction in seizure rate from baseline during the entire double-blind phase was measured. The median percent reductions in seizure rates and the responder rates (fraction of patients with at least a 50% reduction) by treatment group for each study are shown below in Table 2. As described above, a global improvement in seizure severity was also assessed in the Lennox-Gastaut trial.
Table 2: Efficacy Results in Double-Blind, Placebo-Controlled, Add-On Trials
Target Topiramate Dosage (mg/day)Protocol Efficacy ResultsPlacebo2004006008001,0006 mg/kg/day*Partial Onset Seizures Studies in AdultsYDN45454546Median % Reduction11.627.2a47.5b44.7c% Responders182444d46dYEN47484847Median % Reduction1.740.8c41c36c% Responders940c41c36dY1N2423Median % Reduction1.140.7e% Responders835dY2N3030Median % Reduction-12.246.4f% Responders1047cY3N2828Median % Reduction-20.624.3c% Responders043c119N91168Median % Reduction2044.2c% Responders2445cStudies in Pediatric PatientsYPN4541Median % Reduction10.533.1d% Responders2039Primary Generalized Tonic-ClonichYTCN4039Median % Reduction956.7d% Responders2056cLennox-Gastaut SyndromeiYLN4946Median % Reduction-5.114.8d% Responders1428gImprovement in Seizure Severityj2852dSubset analyses of the antiepileptic efficacy of topiramate tablets in these studies showed no differences as a function of gender, race, age, baseline seizure rate or concomitant AED.

INDICATIONS & USAGE

Monotherapy Epilepsy



Adjunctive Therapy Epilepsy


TOPIRAMATE CONTRAINDICATIONS



WARNINGS










Acute Myopia and Secondary Angle Closure Glaucoma



Oligohidrosis and Hyperthermia



















Sudden Unexplained Death in Epilepsy (SUDEP)


PRECAUTIONS

Hyperammonemia and Encephalopathy Associated with Concomitant Valproic Acid Use





Kidney Stones




Paresthesia


Adjustment of Dose in Renal Failure
DOSAGE AND ADMINISTRATION

Decreased Hepatic Function


INFORMATION FOR PATIENTS



PRECAUTIONS: Kidney Stones



LABORATORY TESTS

WARNINGS

DRUG INTERACTIONS



Antiepileptic Drugs










PRECAUTIONS: Hyperammonemia and Encephalopathy Associated with Concomitant Valproic Acid Use

Other Drug Interactions

Digoxin


CNS Depressants


Oral Contraceptives


Hydrochlorothiazide (HCTZ)


Pioglitazone


Lithium


Haloperidol


Amitriptyline


Sumatriptan


Risperidone


Propranolol


Dihydroergotamine


Others


DRUG & OR LABORATORY TEST INTERACTIONS



CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY





PREGNANCY

Pregnancy Category C.









LABOR & DELIVERY




NURSING MOTHERS



PEDIATRIC USE

WARNINGS

GERIATRIC USE

CLINICAL PHARMACOLOGYDOSAGE AND ADMINISTRATION

Race and Gender Effects


TOPIRAMATE ADVERSE REACTIONS



Monotherapy Epilepsy










Adjunctive Therapy Epilepsy





Incidence in Epilepsy Controlled Clinical Trials - Adjunctive Therapy - Partial Onset Seizures, Primary Generalized Tonic-Clonic Seizures and Lennox-Gastaut Syndrome



Other Adverse Events Observed During Double-Blind Epilepsy Adjunctive Therapy Trials






Incidence in Study 119 - Add-On Therapy - Adults with Partial Onset Seizures












Other Adverse Events Observed During All Epilepsy Clinical Trials























Post-Marketing and Other Experience



DRUG ABUSE AND DEPENDENCE



OVERDOSAGE


WARNINGS



DOSAGE & ADMINISTRATION

Epilepsy




Monotherapy Use


Adjunctive Therapy Use

Adults (17 Years of Age and Over) - Partial Seizures, Primary Generalized Tonic-Clonic Seizures or Lennox-Gastaut Syndrome

CLINICAL STUDIES: Adjunctive Therapy Controlled Trials in Patients with Primary Generalized Tonic-Clonic Seizures

Pediatric Patients (Ages 2 to 16 Years) - Partial Seizures, Primary Generalized Tonic-Clonic Seizures or Lennox-Gastaut Syndrome

CLINICAL STUDIES: Adjunctive Therapy Controlled Trial in Patients with Primary Generalized Tonic-Clonic Seizures

Patients with Renal Impairment


Geriatric Patients (Ages 65 Years and Over)
DOSAGE AND ADMINISTRATION: Patients with Renal ImpairmentCLINICAL PHARMACOLOGY: Special Populations: Age, Gender, and Race

Patients Undergoing Hemodialysis


Patients with Hepatic Disease


HOW SUPPLIED
















TERATOGENIC EFFECTS



SPL MEDGUIDE






  • ●     any sudden decrease in vision with or without eye pain and redness,
  • ●     a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma).
  • ●     These eye problems can lead to permanent loss of vision if not treated. You should call your healthcare provider right away if you have any new eye symptoms.



  • ●     thoughts about suicide or dying
  • ●     attempts to commit suicide
  • ●     new or worse depression
  • ●     new or worse anxiety
  • ●     feeling agitated or restless
  • ●     panic attacks
  • ●     trouble sleeping (insomnia)
  • ●     new or worse irritability
  • ●     acting aggressive, being angry, or violent
  • ●     acting on dangerous impulses
  • ●     an extreme increase in activity and talking (mania)
  • ●     other unusual changes in behavior or mood

  • ●     Stopping topiramate tablets suddenly can cause serious problems.
  • ●     Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.

  • ●     Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.
  • ●     Keep all follow-up visits with your healthcare provider as scheduled.
  • ●     Call your healthcare provider between visits as needed, especially if you are worried about symptoms.


  • ●     to treat certain types of seizures (partial onset seizures and primary generalized tonic-clonic seizures) in people 10 years and older,
  • ●     with other medicines to treat certain types of seizures (partial onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome) in adults and children 2 years and older.


  • ●     have or have had depression, mood problems or suicidal thoughts or behavior
  • ●     have kidney problems, kidney stones or are getting kidney dialysis
  • ●     have a history of metabolic acidosis (too much acid in the blood)
  • ●     have liver problems
  • ●     have osteoporosis, soft bones, or decreased bone density
  • ●     have lung or breathing problems
  • ●     have eye problems, especially glaucoma
  • ●     have diarrhea
  • ●     have a growth problem
  • ●     are on a diet high in fat and low in carbohydrates, which is called a ketogenic diet
  • ●     are having surgery
  • ●     are pregnant or plan to become pregnant. It is not known if topiramate tablets will harm your unborn baby. If you become pregnant while taking topiramate tablets, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of antiepileptic medicine during pregnancy.
  • ●     are breastfeeding. It is not known if topiramate tablets passes into breast milk and if it can harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take topiramate tablets.


  • ●     Valproic acid
  • ●     any medicines that impair or decrease your thinking, concentration, or muscle coordination.
  • ●     birth control pills. Topiramate tablets may make your birth control pills less effective. Tell your healthcare provider if your menstrual bleeding changes while you are taking birth control pills and topiramate tablets.



  • ●     Take topiramate tablets exactly as prescribed.
  • ●     Your healthcare provider may change your dose. Do not change your dose without talking to your healthcare provider.
  • ●     Topiramate tablets should be swallowed whole. Do not chew the tablets. They may leave a bitter taste.
  • ●     Do not store any medicine and food mixture for later use.
  • ●     Topiramate tablets can be taken before, during, or after a meal. Drink plenty of fluids during the day. This may help prevent kidney stones while taking topiramate tablets.
  • ●     If you take too much topiramate tablets, call your healthcare provider or poison control center right away or go to the nearest emergency room.
  • ●     If you miss a single dose of topiramate tablets, take it as soon as you can. However, if you are within 6 hours of taking your next scheduled dose, wait until then to take your usual dose of topiramate tablets, and skip the missed dose. Do not double your dose. If you have missed more than one dose, you should call your healthcare professional for advice.
  • ●     Do not stop taking topiramate tablets without talking to your healthcare provider. Stopping topiramate tablets suddenly may cause serious problems. If you have epilepsy and you stop taking topiramate tablets suddenly, you may have seizures that do not stop. Your healthcare provider will tell you how to stop taking topiramate tablets slowly.
  • ●     Your healthcare provider may do blood tests while you take topiramate tablets.

  • ●     Do not drink alcohol while taking topiramate tablets. Topiramate tablets and alcohol can affect each other causing side effects such as sleepiness and dizziness.
  • ●     Do not drive a car or operate heavy machinery until you know how topiramate tablet affects you. Topiramate tablets can slow your thinking and motor skills, and/or vision.




  • ●     tiredness
  • ●     loss of appetite
  • ●     irregular heartbeat
  • ●     impaired consciousness






  • ●     tingling of the arms and legs (paresthesia)
  • ●     not feeling hungry
  • ●     nausea
  • ●     a change in the way foods taste
  • ●     diarrhea
  • ●     weight loss
  • ●     nervousness
  • ●     upper respiratory tract infection




  • ●     Store topiramate tablets at 20- 25(68- 77- 30(59- 86[see USP Controlled Room Temperature]. PROTECT FROM MOISTURE.
  • ●     Keep topiramate tablets in a tightly closed container.
  • ●     Keep topiramate tablets and all medicines out of the reach of children.









PACKAGE LABEL.PRINCIPAL DISPLAY PANEL SECTION














Topiramate

Topiramate

Topiramate

Topiramate TABLET

Product Information

Product Type Human prescription drug label Item Code (Source) NDC:49349-402(NDC:13668-032)
Route of Administration ORAL DEA Schedule

Active Ingredient/Active Moiety

Ingredient Name Basis of Strength Strength
TOPIRAMATE TOPIRAMATE 50 mg

Inactive Ingredients

Ingredient Name Strength
SILICON DIOXIDE
HYPROMELLOSES
lactose monohydrate
MAGNESIUM STEARATE
cellulose, microcrystalline
polyethylene glycol 400
SODIUM STARCH GLYCOLATE TYPE A POTATO
talc
titanium dioxide
FERRIC OXIDE YELLOW

Product Characteristics

Color Size Imprint Code Shape
yellow 6 mm 1032;50 ROUND

Packaging

# Item Code Package Description Marketing Start Date Marketing End Date
1 NDC:49349-402-02 30 in 1 BLISTER PACK

Marketing Information

Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA079153 2011-07-20


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