section name header

Pronunciation

toe-PEER-a-mate

Classifications

Therapeutic Classification: anticonvulsants

Indications

REMS

Unlabeled Uses:

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: 80% absorbed following oral administration.

Distribution: Minimally distributed to tissues.

Metabolism/Excretion: Not extensively metabolized. 70% excreted unchanged in urine.

Half-life: Immediate release: 21 hr; Extended release: 31 hr.

Time/Action Profile

(plasma concentrations†)

ROUTEONSETPEAKDURATION
POunknown2 hr12 hr
PO-ERunknown24 hrunknown

†After single dose.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: oligohydrosis ( in children), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

EENT: abnormal vision, diplopia, nystagmus, intraocular pressure, acute myopia/secondary angle closure glaucoma, mydriasis, ocular pain, ocular redness, retinal detachment, visual field defects.

Endo: growth (children).

F and E: hyperchloremic metabolic acidosis.

GI: nausea, abdominal pain, anorexia, constipation, dry mouth, hyperammonemia.

GU: kidney stones.

Hemat: BLEEDING, leukopenia.

Metab: weight loss, hyperthermia ( in children).

MS: bone mineral density ( in children).

Neuro: ataxia, cognitive disorders, dizziness, drowsiness, fatigue, impaired concentration/memory, nervousness, paresthesia, psychomotor slowing, sedation, speech problems, aggressive reaction, agitation, anxiety, confusion, depression, encephalopathy, malaise, mood problems, SEIZURES, SUICIDAL THOUGHTS, tremor.
Misc: fever.

Interactions

Drug-Drug:

Route/Dosage

see Calculator

Epilepsy (monotherapy)

Renal Impairment

Epilepsy (adjunctive therapy)

Renal Impairment

Migraine Prevention

Renal Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Eprontia, Qudexy XR, Topamax, Topamax Sprinkle, Trokendi XR