section name header

Pronunciation

toe-PEER-a-mate

Classifications

Therapeutic Classification: anticonvulsants, mood stabilizers

Indications

REMS


Unlabeled Use:

Action

  • Action may be due to:
    • Blockade of sodium channels in neurons,
    • Enhancement of gamma-aminobutyrate, an inhibitory neurotransmitter,
    • Prevention of activation of excitatory receptors.
Therapeutic effects:
  • Decreased incidence of seizures.
  • Decreased incidence/severity of migraine headache.

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

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

Code

NDC Code