Buy Topamax (Topiramate) tablets online
How and where to order Topiramate (Topamax) 25 mg, 50 mg, 100 mg, 200 mg tablets online:
Indications and usage:
Topamax (Topiramate) is indicated for:
epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older; adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome in patients 2 years of age and older.
preventive treatment of migraine in patients 12 years of age and older.
alcoholism
cocaine cravings and use
nicotine dependence
overweight, obesity, binge eating disorder, bulimia
chronic pain, fibromyalgia, trigeminal neuralgia, vulvodynia, diabetic peripheral neuropathy
bipolar disorder
borderline personality disorder
Tourette's syndrome
other medical conditions and diseases of nervous system
Contraindications:
None.
Dosage forms and strengths:
Topamax (Topiramate) tablets for oral use 25 mg, 50 mg, 100 mg, 200 mg.
Topamax (Topiramate) sprinkle capsules for oral use 15 mg, 25 mg.
Dosage and administration:
The initial dose, titration, and recommended maintenance dose varies by indication and age group. See full prescribing information for recommended dosage, and dosing considerations in patients with renal impairment, geriatric patients, and patients undergoing hemodialysis.
Warnings and precautions:
Acute myopia and secondary angle closure glaucoma: can lead to permanent visual loss; discontinue Topiramate (Topamax) pills as soon as possible.
Visual field defects: consider discontinuation of this medication.
Oligohidrosis and hyperthermia: monitor decreased sweating and increased body temperature, especially in pediatric patients.
Metabolic acidosis: baseline and periodic measurement of serum bicarbonate is recommended; consider dose reduction or discontinuation of Topamax if clinically appropriate.
Suicidal behavior and ideation: antiepileptic drugs increase the risk of suicidal behavior or ideation.
Cognitive/neuropsychiatric adverse reactions: use caution when operating machinery including cars; depression and mood problems may occur.
Fetal toxicity: use during pregnancy can cause major congenital malformations, including but not limited to cleft lip and/or palate, and being small for gestational age.
Withdrawal of AEDs: withdraw topiramate gradually.
Decrease in bone mineral density: has been shown to decrease bone mineral density and bone mineral content in pediatric patients.
Negative effects on growth (height and weight): may slow height increase and weight gain; carefully monitor children receiving prolonged therapy.
Serious skin reactions: if SJS or TEN is suspected, discontinue this medicine.
Hyperammonemia/encephalopathy: measure ammonia if encephalopathic symptoms occur.
Kidney stones: avoid use with other carbonic anhydrase inhibitors, drugs causing metabolic acidosis, or in patients on a ketogenic diet.
Hypothermia has been reported with and without hyperammonemia during topiramate treatment with concomitant valproic acid use.
Overdosage:
Signs and symptoms included convulsions, drowsiness, speech disturbance, blurred vision, diplopia, impaired mentation, lethargy, abnormal coordination, stupor, hypotension, abdominal pain, agitation, dizziness and depression. The clinical consequences were not severe in most cases, but deaths have been reported after overdoses involving Topamax.
Topiramate overdose has resulted in severe metabolic acidosis.
A patient who ingested a dose of this drug between 96 and 110 g was admitted to a hospital with a coma lasting 20 to 24 hours followed by full recovery after 3 to 4 days.
In the event of overdose, Topamax (Topiramate) capsules or tablets should be discontinued and general supportive treatment given until clinical toxicity has been diminished or resolved. Hemodialysis is an effective means of removing topiramate from the body.
Side effects, adverse reactions:
Most common adverse reactions in adult and pediatric patients were:
Teatment of epilepsy: paresthesia, anorexia, weight loss, speech disorders/related speech problems, fatigue, dizziness, somnolence, nervousness, psychomotor slowing, abnormal vision and fever.
Prevention of migraine: paresthesia, anorexia, weight loss, difficulty with memory, taste perversion, diarrhea, hypoesthesia, nausea, abdominal pain and upper respiratory tract infection.
To report suspected side effects of Topamax (Topiramate) capsules or tablets contact Janssen pharmaceutical company or your local FDA.
Drug interactions:
Contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day.
Monitor lithium levels if lithium is used with high-dose of this medication.
Usage in specific populations:
Pregnancy
Topiramate can cause fetal harm when administered to a pregnant woman.
Lactation
Topamax is excreted in human milk. The effects of this medicine on milk production are unknown. Diarrhea and somnolence have been reported in breastfed infants whose mothers receive topiramate treatment.
Females and males of reproductive potential
Contraception: women of childbearing potential who are not planning a pregnancy should use effective contraception because of the risk of major congenital malformations, including oral clefts, and the risk of infants being SGA.
Pediatric use
The safety and effectiveness of Topamax as adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome have been established in pediatric patients 2 years of age and older.
Geriatric use
Topiramate dosage adjustment may be necessary for elderly with age-related renal impairment (creatinine clearance rate < 70 mL/min/1.73 m2) resulting in reduced clearance.
Renal impairment
The clearance of this drug is reduced in patients with moderate (creatinine clearance 30 to 69 mL/min/1.73 m2) and severe (creatinine clearance < 30 mL/min/1.73 m2) renal impairment. A dosage adjustment is recommended in patients with moderate or severe renal impairment.
Patients undergoing hemodialysis
Topamax (Topiramate) is cleared by hemodialysis at a rate that is 4 to 6 times greater than in a normal individual. A dosage adjustment may be required.
Patient counseling information:
Advise the patient to read the FDA-approved medication guide.
Eye disorders
Instruct patients taking Topiramate (Topamax) tablets or capsules to seek immediate medical attention if they experience blurred vision, visual disturbances, or periorbital pain.
Oligohidrosis and hyperthermia
Closely monitor Topamax-treated patients, especially pediatric patients, for evidence of decreased sweating and increased body temperature, especially in hot weather. Counsel patients to contact their healthcare professionals immediately if they develop a high or persistent fever, or decreased sweating.
Metabolic acidosis
Warn patients about the potential significant risk for metabolic acidosis that may be asymptomatic and may be associated with adverse effects on kidneys (e.g., kidney stones, nephrocalcinosis), bones (e.g., osteoporosis, osteomalacia, and/or rickets in children), and growth (e.g., growth delay/retardation) in pediatric patients, and on the fetus.
Suicidal behavior and ideation
Counsel patients, their caregivers, and families that AEDs, including this medication, may increase the risk of suicidal thoughts and behavior, and advise of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior or the emergence of suicidal thoughts, or behavior or thoughts about self-harm. Instruct patients to immediately report behaviors of concern to their healthcare providers.
Interference with cognitive and motor performance
Warn patients about the potential for somnolence, dizziness, confusion, difficulty concentrating, or visual effects, and advise patients not to drive or operate machinery until they have gained sufficient experience on Topamax to gauge whether it adversely affects their mental performance, motor performance, and/or vision.
Even when taking this medicine or other anticonvulsants, some patients with epilepsy will continue to have unpredictable seizures. Therefore, advise all patients taking topiramate for epilepsy to exercise appropriate caution when engaging in any activities where loss of consciousness could result in serious danger to themselves or those around them (including swimming, driving a car, climbing in high places, etc.). Some patients with refractory epilepsy will need to avoid such activities altogether. Discuss the appropriate level of caution with patients, before patients with epilepsy engage in such activities.
Fetal toxicity
Inform pregnant women and women of childbearing potential that use of Topamax (Topiramate) pills during pregnancy can cause fetal harm. This drug increases the risk of major congenital malformations, including but not limited to cleft lip and/or cleft palate (oral clefts), which occur early in pregnancy before many women know they are pregnant. Also inform patients that infants exposed to topiramate monotherapy in utero may be SGA. There may also be risks to the fetus from chronic metabolic acidosis with use of Topamax during pregnancy. When appropriate, counsel pregnant women and women of childbearing potential about alternative therapeutic options.
Advise women of childbearing potential who are not planning a pregnancy to use effective contraception while using this medication, keeping in mind that there is a potential for decreased contraceptive efficacy when using estrogen-containing or progestin-only contraceptives with topiramate.
Encourage pregnant women using Topamax, to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The registry is collecting information about the safety of antiepileptic drugs during pregnancy.
Decrease in bone mineral density
Inform the patient or caregiver that long-term treatment with this medicine can decrease bone formation and increase bone resorption in children.
Negative effects on growth (height and weight)
Discuss with the patient or caregiver that long-term Topiramate (Topamax) treatment may attenuate growth as reflected by slower height increase and weight gain in pediatric patients.
Serious skin reactions
Inform patients about the signs of serious skin reactions. Instruct patients to immediately inform their healthcare provider at the first appearance of skin rash.
Hyperammonemia and encephalopathy
Warn patients about the possible development of hyperammonemia with or without encephalopathy. Although hyperammonemia may be asymptomatic, clinical symptoms of hyperammonemic encephalopathy often include acute alterations in level of consciousness and/or cognitive function with lethargy and/or vomiting. This hyperammonemia and encephalopathy can develop with Topamax treatment alone or with concomitant valproic acid.
Instruct patients to contact their physician if they develop unexplained lethargy, vomiting, or changes in mental status.
Kidney stones
Instruct patients, particularly those with predisposing factors, to maintain an adequate fluid intake in order to minimize the risk of kidney stone formation.
Instructions for a missing dose
Instruct patients that if they miss a single dose of Topiramate (Topamax) tablets or capsules, it should be taken as soon as possible. However, if a patient is within 6 hours of taking the next scheduled dose, tell the patient to wait until then to take the usual dose of this medication, and to skip the missed dose. Tell patients that they should not take a double dose in the event of a missed dose. Advise patients to contact their healthcare provider if they have missed more than one dose.
Where to buy topiramate online:
To purchase Topamax (Topiramate) 25 mg, 50 mg, 100 mg, 200 mg tablets from reliable online pharmacies and drugstores at low prices please use resources described above on this webpage.
Here is a list of popular medications containing topiramate as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:
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Sellers: | TOPIRAMATE STORES |
Prices: | from $0.75 per pill |
Forms: | 25 mg, 50 mg, 100 mg, 200 mg capsules or tablets |
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Type: | Topiramate brand and generics |
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Delivery: | Regular and express mail service |
Shipping: | Worldwide, including USA, UK, Europe, Canada, Australia |
Indications and usage:
Topamax (Topiramate) is indicated for:
Contraindications:
None.
Dosage forms and strengths:
Dosage and administration:
The initial dose, titration, and recommended maintenance dose varies by indication and age group. See full prescribing information for recommended dosage, and dosing considerations in patients with renal impairment, geriatric patients, and patients undergoing hemodialysis.
Warnings and precautions:
Overdosage:
Signs and symptoms included convulsions, drowsiness, speech disturbance, blurred vision, diplopia, impaired mentation, lethargy, abnormal coordination, stupor, hypotension, abdominal pain, agitation, dizziness and depression. The clinical consequences were not severe in most cases, but deaths have been reported after overdoses involving Topamax.
Topiramate overdose has resulted in severe metabolic acidosis.
A patient who ingested a dose of this drug between 96 and 110 g was admitted to a hospital with a coma lasting 20 to 24 hours followed by full recovery after 3 to 4 days.
In the event of overdose, Topamax (Topiramate) capsules or tablets should be discontinued and general supportive treatment given until clinical toxicity has been diminished or resolved. Hemodialysis is an effective means of removing topiramate from the body.
Side effects, adverse reactions:
Most common adverse reactions in adult and pediatric patients were:
To report suspected side effects of Topamax (Topiramate) capsules or tablets contact Janssen pharmaceutical company or your local FDA.
Drug interactions:
Usage in specific populations:
Pregnancy
Topiramate can cause fetal harm when administered to a pregnant woman.
Lactation
Topamax is excreted in human milk. The effects of this medicine on milk production are unknown. Diarrhea and somnolence have been reported in breastfed infants whose mothers receive topiramate treatment.
Females and males of reproductive potential
Contraception: women of childbearing potential who are not planning a pregnancy should use effective contraception because of the risk of major congenital malformations, including oral clefts, and the risk of infants being SGA.
Pediatric use
The safety and effectiveness of Topamax as adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome have been established in pediatric patients 2 years of age and older.
Geriatric use
Topiramate dosage adjustment may be necessary for elderly with age-related renal impairment (creatinine clearance rate < 70 mL/min/1.73 m2) resulting in reduced clearance.
Renal impairment
The clearance of this drug is reduced in patients with moderate (creatinine clearance 30 to 69 mL/min/1.73 m2) and severe (creatinine clearance < 30 mL/min/1.73 m2) renal impairment. A dosage adjustment is recommended in patients with moderate or severe renal impairment.
Patients undergoing hemodialysis
Topamax (Topiramate) is cleared by hemodialysis at a rate that is 4 to 6 times greater than in a normal individual. A dosage adjustment may be required.
Patient counseling information:
Advise the patient to read the FDA-approved medication guide.
Eye disorders
Instruct patients taking Topiramate (Topamax) tablets or capsules to seek immediate medical attention if they experience blurred vision, visual disturbances, or periorbital pain.
Oligohidrosis and hyperthermia
Closely monitor Topamax-treated patients, especially pediatric patients, for evidence of decreased sweating and increased body temperature, especially in hot weather. Counsel patients to contact their healthcare professionals immediately if they develop a high or persistent fever, or decreased sweating.
Metabolic acidosis
Warn patients about the potential significant risk for metabolic acidosis that may be asymptomatic and may be associated with adverse effects on kidneys (e.g., kidney stones, nephrocalcinosis), bones (e.g., osteoporosis, osteomalacia, and/or rickets in children), and growth (e.g., growth delay/retardation) in pediatric patients, and on the fetus.
Suicidal behavior and ideation
Counsel patients, their caregivers, and families that AEDs, including this medication, may increase the risk of suicidal thoughts and behavior, and advise of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior or the emergence of suicidal thoughts, or behavior or thoughts about self-harm. Instruct patients to immediately report behaviors of concern to their healthcare providers.
Interference with cognitive and motor performance
Warn patients about the potential for somnolence, dizziness, confusion, difficulty concentrating, or visual effects, and advise patients not to drive or operate machinery until they have gained sufficient experience on Topamax to gauge whether it adversely affects their mental performance, motor performance, and/or vision.
Even when taking this medicine or other anticonvulsants, some patients with epilepsy will continue to have unpredictable seizures. Therefore, advise all patients taking topiramate for epilepsy to exercise appropriate caution when engaging in any activities where loss of consciousness could result in serious danger to themselves or those around them (including swimming, driving a car, climbing in high places, etc.). Some patients with refractory epilepsy will need to avoid such activities altogether. Discuss the appropriate level of caution with patients, before patients with epilepsy engage in such activities.
Fetal toxicity
Inform pregnant women and women of childbearing potential that use of Topamax (Topiramate) pills during pregnancy can cause fetal harm. This drug increases the risk of major congenital malformations, including but not limited to cleft lip and/or cleft palate (oral clefts), which occur early in pregnancy before many women know they are pregnant. Also inform patients that infants exposed to topiramate monotherapy in utero may be SGA. There may also be risks to the fetus from chronic metabolic acidosis with use of Topamax during pregnancy. When appropriate, counsel pregnant women and women of childbearing potential about alternative therapeutic options.
Advise women of childbearing potential who are not planning a pregnancy to use effective contraception while using this medication, keeping in mind that there is a potential for decreased contraceptive efficacy when using estrogen-containing or progestin-only contraceptives with topiramate.
Encourage pregnant women using Topamax, to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The registry is collecting information about the safety of antiepileptic drugs during pregnancy.
Decrease in bone mineral density
Inform the patient or caregiver that long-term treatment with this medicine can decrease bone formation and increase bone resorption in children.
Negative effects on growth (height and weight)
Discuss with the patient or caregiver that long-term Topiramate (Topamax) treatment may attenuate growth as reflected by slower height increase and weight gain in pediatric patients.
Serious skin reactions
Inform patients about the signs of serious skin reactions. Instruct patients to immediately inform their healthcare provider at the first appearance of skin rash.
Hyperammonemia and encephalopathy
Warn patients about the possible development of hyperammonemia with or without encephalopathy. Although hyperammonemia may be asymptomatic, clinical symptoms of hyperammonemic encephalopathy often include acute alterations in level of consciousness and/or cognitive function with lethargy and/or vomiting. This hyperammonemia and encephalopathy can develop with Topamax treatment alone or with concomitant valproic acid.
Instruct patients to contact their physician if they develop unexplained lethargy, vomiting, or changes in mental status.
Kidney stones
Instruct patients, particularly those with predisposing factors, to maintain an adequate fluid intake in order to minimize the risk of kidney stone formation.
Instructions for a missing dose
Instruct patients that if they miss a single dose of Topiramate (Topamax) tablets or capsules, it should be taken as soon as possible. However, if a patient is within 6 hours of taking the next scheduled dose, tell the patient to wait until then to take the usual dose of this medication, and to skip the missed dose. Tell patients that they should not take a double dose in the event of a missed dose. Advise patients to contact their healthcare provider if they have missed more than one dose.
Where to buy topiramate online:
To purchase Topamax (Topiramate) 25 mg, 50 mg, 100 mg, 200 mg tablets from reliable online pharmacies and drugstores at low prices please use resources described above on this webpage.
Here is a list of popular medications containing topiramate as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:
Trade name of the drug | Pharmaceutical forms and doses | Companies |
Epimate | ||
Epitomax | ||
Eprontia | ||
Qudexy XR | ||
Topamax | ||
Trokendi XR |