Topiramate
Medication used to treat epilepsy and migraine / From Wikipedia, the free encyclopedia
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Topiramate, sold under the brand name Topamax among others, is a medication used to treat epilepsy and prevent migraines.[9] It has also been used in alcohol dependence and essential tremor.[9] For epilepsy this includes treatment for generalized or focal seizures.[10] It is taken orally (by mouth).[9]
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Trade names | Topamax, Trokendi XR, Qudexy XR, others |
Other names | Topiramic acid |
AHFS/Drugs.com | Monograph |
MedlinePlus | a697012 |
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Routes of administration | Oral |
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Bioavailability | 80% |
Protein binding | 13–17%; 15–41% |
Metabolism | Liver (20–30%) |
Elimination half-life | 21 hours |
Excretion | Urine (70–80%) |
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ECHA InfoCard | 100.129.713 |
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Formula | C12H21NO8S |
Molar mass | 339.36 g·mol−1 |
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Common side effects include tingling, feeling tired, loss of appetite, abdominal pain, weight loss,[11] and decreased cognitive function such as trouble concentrating.[9][10] Serious side effects may include suicide, increased ammonia levels resulting in encephalopathy, and kidney stones.[9] Topiramate can cause birth defects including cleft lip and palate.[12] Risk/benefit should be carefully discussed with the full treatment team. Topiramate is considered "probably compatible" with lactation and is not contraindicated in breastfeeding, though monitoring of the infant for diarrhea or poor weight gain may be considered.[13][14] The mechanism of action is unclear.[9]
Topiramate was approved for medical use in the United States in 1996.[9] It is available as a generic medication.[10][15][16] In 2021, it was the 66th most commonly prescribed medication in the United States, with more than 10 million prescriptions.[17][18]