{"id":2247,"date":"2023-06-25T17:54:34","date_gmt":"2023-06-25T17:54:34","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/topiramate\/"},"modified":"2023-06-25T18:10:20","modified_gmt":"2023-06-25T18:10:20","slug":"topiramate","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/topiramate\/","title":{"rendered":"Topiramate"},"content":{"rendered":"

<\/p>\n

CLINICAL USE<\/h3>\n

Anti-epileptic agent Prophylactic treatment of migraine<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

Epilepsy: 50\u2013400 mg twice daily Migraine: Initially, 25 mg at night. Maintenance, 25\u201350 mg twice daily<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           : 339.4<\/li>\n
  • %Protein binding                           : 9\u201317<\/li>\n
  • %Excreted unchanged in urine     : 70<\/li>\n
  • Volume of distribution (L\/kg)       : 0.55\u20130.8<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      : 20\u201330\/48\u201360 (12\u201315 hours if used with another enzyme-inducing anti-epileptic drug)
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Migraine\/epilepsy: Dose as in normal renal function<\/li>\n
  • 10 to 20     : Migraine: Dose as in normal renal function Epilepsy: 50% of normal dose and increase according to response<\/li>\n
  • <10           : Migraine: Dose as in normal renal function Epilepsy: 25\u201350% of normal dose and increase according to response
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                : Unknown dialysability. Dose as for GFR <10 mL\/min<\/li>\n
  • HD                     : Dialysed. Dose as for GFR <10 mL\/min<\/li>\n
  • HDF\/high flux   : Dialysed. Dose as for GFR <10 mL\/min<\/li>\n
  • CAV\/VVHD      : Unknown dialysability. Dose as for GFR 10 to 20 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Antidepressants: antagonism of anticonvulsant effect<\/li>\n
  • Anti-epileptics: concentration reduced by phenytoin and carbamazepine; increases phenytoin concentration<\/li>\n
  • Antimalarials: mefloquine antagonises anticonvulsant effect; chloroquine and hydroxychloroquine occasionally reduces convulsive threshold Oestrogens and progestogens: reduced contraceptive effect
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    Oral<\/p>\n

    Rate of Administration<\/h4>\n

    \u2013<\/p>\n

    Comments<\/h4>\n

    \u2013<\/p>\n

    OTHER INFORMATION<\/h4>\n

    Patients with moderate to severe renal impairment may take 10\u201315 days to reach steady state, compared to 4\u20138 days in patients with normal renal function A higher frequency of renal stones has been noted in topiramate treated patients, although the risk is not related to dose or duration of therapy. Adequate hydration is recommended to reduce this risk .<\/li>\n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Anti-epileptic agent Prophylactic treatment of migraine DOSE IN<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-2247","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=2247"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2247\/revisions"}],"predecessor-version":[{"id":2353,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2247\/revisions\/2353"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=2247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=2247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=2247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}