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Topamax for obesity
Using and Administration
Inside, regardless of the meal
To achieve optimal control of epileptic seizures in children and adults are recommended to start treatment with low doses of the drug taking, followed by gradual titration to effective dose.
Capsules are intended for patients who have difficulties with swallowing tablets (eg children and does topamax cause weight loss elderly patients). In such cases, the capsule Topamax should be carefully opened, its contents mixed with a small amount (about 1 level spoon) any soft food. This mixture should be swallowed immediately without chewing. Do not store medicine mixed with food until the next reception. Topamax pills can be swallowed whole and.
Use in combination with other anticonvulsants in adult patients. Usually, total daily dose ranges from 200 to 400 mg taken in 2 divided doses. Some patients may need to increase to a maximum daily dose – 1600 mg. It is recommended to start treatment with low doses followed by gradual selection of effective dose. In the future, at weekly or 2-week intervals the dose can be increased to 25-50 mg and take it in 2 hours. If dosage topamax side effects must be guided by clinical effect. In some patients, the effect can be achieved while taking the drug 1 time a day. To achieve optimal therapeutic effect, drug Topamax is not necessary to control its concentration in plasma.
The recommendations for dosage applicable to all adult patients, including older people, if they have kidney disease (see “Cautions”).
The recommended total daily dose of the drug topamax side effects as a means of adjuvant therapy is 5 to 9 mg / kg and was adopted in 2 hours. Dosage should begin with 25 mg (or less, based on the initial dose – 1 to 3 mg / kg / day), taking them at night for 1 week. In the future, at weekly or 2-week intervals the dose can be increased by 1-3 mg / kg, and take it in 2 hours.
Topamax side effects the overall situation. If you cancel concomitant anticonvulsants in order to take into account the possible impact of this step on the frequency of seizures. In cases where there is no need to abruptly cancel the concomitant anticonvulsants for security reasons, it is recommended to reduce their dose gradually reducing the dose of concomitant antiepileptic drugs for 1 / 3 every 2 weeks.
With the abolition of drugs that are inducers of hepatic enzymes, the concentration of topamax side effects in the blood will increase. In such situations, if clinically indicated dose of the drug Topamax can be reduced.
Then increase the dose at intervals of 1-2 weeks at 25 or 50 mg (daily dose divided into does topamax cause weight loss). If the patient does not tolerate such treatment dose increase, then you can increase the intervals between the dose topamax side effects, or increase the dose more gradually. The initial dose of topamax side effects in adults is 100 mg / day, and the maximum daily dose should not exceed 500 mg. Some patients with refractory epilepsy tolerate topamax side effects at doses up to 1000 mg / day. Recommendations for dosage are all adults, including elderly patients not suffering from kidney disease.
Children older than 2 years in the first week of treatment should be given topamax side effects at a dose of 0,5-1 mg / kg of body weight before bedtime. Then increase the dose at intervals does topamax cause weight loss). If the child does not tolerate such a regime of increasing doses, it can raise the dose more slowly or increase the interval between dose topamax side effects. The value of dose and its rate of increase should be determined by clinical results.
The recommended dosage range for topamax side effects in children older than 2 years is 3.6 mg / kg / day. Children c newly diagnosed partial seizures can assign up to 500 mg / day.
The recommended total daily dose of topamax side effects for the prevention of migraine attacks is 100 mg in 2 divided doses. At the beginning of treatment the patient should take 25 mg of Topamax at bedtime for 1 week. Then increase the dose at intervals of 1 week at 25 mg / day. If the patient does not tolerate such treatment dose increase, then you can increase the intervals between the dose topamax side effects, or increase the dose more gradually.
In some patients the positive results achieved at a daily dose of topiramate at 50 mg. In clinical studies, patients received different daily doses of topiramate, but not more than 200 mg / day.
Cautions
Antiepileptic drugs, including drug Topamax, should be lifted gradually, to minimize the possibility of increasing the frequency of seizures. In clinical trials the dose was reduced by 50-100 mg at weekly intervals for the treatment of adults with epilepsy and 25-50 mg in adults receiving 100 mg / day the drug Topamax to prevent migraines. The children in clinical trials the drug Topamax gradually abolished within 2.8 weeks. If for medical reasons need quick removal of the drug Topamax, it is recommended to exercise appropriate control of the patient.
Speed excretion by the kidney depends on renal function and does not depend on age. In patients with moderate or severe renal impairment in order to achieve stable plasma concentrations may need from does topamax cause weight loss to 15 days, as opposed to 4-8 days in patients with normal renal function.
As with any illness, dose selection scheme should be guided by clinical effect (ie the degree of control the seizures, the absence of side effects does topamax cause weight loss) and take into account that patients with impaired renal function to establish a stable plasma concentration for each dose may need more long time.
When topamax weight loss therapy is very important to adequately increase the volume of fluid intake can reduce the risk of topamax weight loss, as well as side effects that may arise under the influence of physical activity or high temperatures.
In the treatment of t topamax weight loss observed an increased incidence of mood disorders and depression.
Suicide attempts. In conducting double-blind clinical studies using topamax weight loss in approved and investigational indications, suicide attempts occurred at a frequency of 0,003 while taking topamax weight loss (13 cases among 3999 topamax weight loss) with placebo – a rate of 0 (0 cases among 430 patients). It was noted that a completed suicide attempt in a clinical study on the application of the drug in bipolar disorder.
In some patients, especially with a predisposition to topamax weight loss may increase the risk of kidney stones and the appearance of related symptoms, such as renal colic. To reduce this risk, should be an adequate increase in the volume of fluid intake.
Topamax weight loss is a history (including family), topamax weight loss, concomitant therapy drugs, which contribute to the development of nephrolithiasis.
Patients with impaired hepatic function topiramate should be used with caution because of possible reduction in clearance of the drug.
In applying the drug Topamax described syndrome, including acute myopia associated with secondary angle-closure glaucoma. Symptoms include a sharp reduction in visual acuity and / or pain in the eye. At Ophthalmologic examination can be found myopia, flattening of the anterior chamber of the eye, hyperemia (redness) of the eyeball, increased intraocular pressure. Topamax weight loss may be observed. This syndrome may be accompanied by secretion of fluid, leading to a shift of the lens and the iris forward with the development of secondary angle-closure glaucoma. Symptoms usually appear 1 month after the beginning of the drug Topamax. In contrast to primary open-angle glaucoma, which is rarely observed in patients up to 40 years of age, secondary angle-closure glaucoma occurs when using topamax weight loss in adults and children. If you have a syndrome, including myopia associated with angle-closure glaucoma treatment includes discontinuation of the drug Topamax, as soon as the physician deems it feasible, and appropriate measures aimed at lowering intraocular pressure. Typically, these measures lead to normalization of intraocular pressure.
Elevated intraocular pressure of any etiology in the absence of adequate treatment may lead to serious complications, even blindness.
In the application of topamax weight loss may occur hyperchloraemic not associated with a deficit of anions, metabolic acidosis (eg, reduced concentration of bicarbonate in plasma below the normal level in the absence of respiratory alkalosis). This decrease in concentration of serum bicarbonate is a consequence of inhibitory effect of does topamax cause weight loss on renal topamax weight loss. In most cases, reducing the concentration of bicarbonate occurs at the beginning of the drug, although this effect may occur in any period of topiramate treatment. The level of concentration reduction is usually weak or moderate (mean of topamax weight loss when used in adult patients at a dose above 100 mg / day and about 6 mg / kg / day when used in pediatric patients). In rare cases, patients have reduced concentrations of bicarbonate below topamax weight loss. Some diseases or treatments that predispose to the development of acidosis (eg renal disease, severe respiratory diseases, status epilepticus, diarrhea, surgery, topamax weight loss diet, topamax weight loss medications) may be additional factors contributing to bicarbonate-lowering effect of topiramate.
In children, chronic metabolic acidosis can lead to slower growth. Effect of topiramate on growth and possible complications associated with the skeletal system have not been studied systematically in children and adults.
In connection with the foregoing, in the treatment of topiramate is recommended to conduct the necessary studies, including determination of the concentration of bicarbonate in serum. In the event of metabolic acidosis and its persistence, it is recommended to reduce the dose or stop taking does topamax cause weight loss.
If a patient loses weight in the treatment of drug Topamax for obesity, it is necessary to consider the desirability of increasing supply.
The drug Topamax affects the central nervous system and can cause drowsiness, dizziness and other symptoms. It can also cause blurred vision. These adverse effects can be dangerous for patients, for driving and moving mechanisms, particularly at a time until you set an individual patient’s reaction to the drug.
