Topsaver - Instructions For Use, Price, Reviews, Analogs, Tablets

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Topsaver

Topsaver: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Topsaver

ATX code: N03AX11

Active ingredient: topiramate (Topiramate)

Manufacturer: Pliva Hrvatska, d.o.o. (Pliva Hrvatska, doo) (Croatia); Teva Pharmaceutical Enterprises, Ltd. (Teva Pharmaceutical Industries, Ltd.) (Israel)

Description and photo updated: 2018-29-11

Prices in pharmacies: from 169 rubles.

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Topsaver is an antiepileptic drug.

Release form and composition

• film-coated tablets: biconvex, round, 25 mg - white, 50 mg - light yellow, 100 mg - yellow, 200 mg - grayish-pink; on one side marked "TO", on the other side - dosage (tablets 25, 50, 100 mg, 14 pcs. in a blister, in a cardboard box 2 blisters; 200 mg tablets, 7 pcs. in a blister, in a cardboard box 4 blisters; for hospitals 25, 50, 100 mg tablets in "in-bulk" packaging of 15 kg in a double plastic bag, in a cardboard drum 1 bag);
• capsules: 25 mg - size No. 1, 50 mg - size No. 0, gelatinous, hard, white lid and body with black ink inscription on the lid “TEVA”, on the body the inscription “7336” (25 mg) and “50 mg” (50 mg); the contents of the capsules are pellets from almost white to yellow with a slight brown tint (60 pcs. in a bottle made of polyethylene, in a cardboard box 1 bottle).

Each pack also contains instructions for using Topsaver.

1 tablet contains:

• active substance: topiramate - 25, 50, 100 or 200 mg;
• additional components: pregelatinized starch, lactose monohydrate, partially pregelatinized starch, sodium carboxymethyl starch, microcrystalline cellulose, magnesium stearate;
• film shell: polysorbate-80, hypromellose, titanium dioxide, talc; iron oxide yellow (E172) - for 50 and 100 mg, iron oxide red (E172) - for 200 mg.

1 capsule contains:

• active substance: topiramate - 25 or 50 mg;
• additional components: povidone-K30, macrogol-6000, ethylcellulose, sugar crumbs (sucrose, starch syrup), talc, triethyl citrate;
• capsule shell: titanium dioxide, gelatin, ink 10A1 (S-1-277002) black *.

* ink composition: ammonium hydroxide, propylene glycol, shellac, butanol, ethanol, water, isopropanol.

Pharmacological properties

Pharmacodynamics

Topsavera's active ingredient, topiramate, is an antiepileptic substance belonging to the class of sulfate-substituted monosaccharides. It has a blocking effect on sodium channels and inhibits the appearance of repeated action potentials during prolonged depolarization of the neuron membrane. Topiramate enhances the effect of gamma-aminobutyric acid (GABA) in relation to certain subtypes of GABA receptors (including GABA _A receptors) and increases the activity of GABA _A themselves-receptors, counteracts the activation of kainate sensitivity / AMPK (α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) -receptors to glutamate. The agent does not alter the activity of N-methyl-D-aspartate (NMDA) towards the NMDA receptor subtype. This effect of topiramate is dose-dependent at its plasma level of 1–200 µmol / L, with the lowest efficacy in the range from 1 to 10 µmol.

In addition, the active ingredient inhibits the activity of certain isoenzymes of carbonic anhydrase. The severity of this pharmacological effect of topiramate is much weaker than that of acetazolamide, which is a well-known carbonic anhydrase inhibitor; therefore, such an effect of topiramate is not among the main manifestations of its antiepileptic activity.

Pharmacokinetics

After oral administration of Topsaver, topiramate is effectively and quickly absorbed from the gastrointestinal tract (GIT), the bioavailability is about 80%. After repeated oral administration 2 times a day at a dose of 100 mg, the average value of the maximum concentration (C _max) of topiramate in plasma is 6.76 μg / ml. Plasma clearance can vary from 20 to 30 ml / min. When used simultaneously with food, there is no significant effect on bioavailability. Pharmacokinetics of topiramate is linear with a dose-dependent increase in its plasma level when using 200-800 mg per day (in the form of capsules).

For a single dose of an active substance not exceeding 1200 mg, the average volume of distribution (V _d) is 0.55–0.8 l / kg. The magnitude of the index depends on the sex, female, she is on average ¹ / ₂ of the values latched in men, due to the high content of women's body adipose tissue.

Plasma clearance is stable, the area under the pharmacokinetic curve (AUC) increases in proportion to the Topsaver dose in the range from 100 to 400 mg. The active substance binds to plasma proteins by 13-17%. It may take 4–8 days to reach a steady-state concentration of the drug in the blood (C _ss) with normal renal activity. Approximately 20% of topiramate undergoes metabolic transformation, up to 50% - against the background of concomitant administration of other antiepileptic drugs (AEDs), which are inducers of microsomal enzymes. Six actually inactive metabolites of the substance were isolated from plasma, urine and feces. Unchanged topiramate and its metabolites are mostly excreted by the kidneys. Half-life (T _1/2) after repeated oral administration of 50 and 100 mg of Topsaver twice a day is 21 hours.

The pharmacokinetics of the active substance in children, as well as in adults, is linear. C _ss funds in plasma increases in proportion to the dose increase. The clearance of topiramate is independent of the dose. At the same time, it should be borne in mind that in children, when compared with adults, the clearance of the drug is increased, and T _1/2 is shorter. As a result, when taking the same dose per 1 kg of body weight in children, the plasma concentration of topiramate in the blood will be less than in adults.

With the help of hemodialysis, topiramate is almost completely removed from the blood plasma.

Indications for use

Film-coated tablets

• monotherapy of epilepsy in patients from 7 years of age (including patients with newly diagnosed disease);
• adjunctive treatment for tonic-clonic seizures, generalized or partial, in patients from 3 years of age with insufficient effect of first-choice AED therapy, as well as for the relief of seizures against the background of Lennox-Gastaut syndrome.

Capsules

• epilepsy: as a monotherapy drug or as part of a combination therapy in patients over 2 years of age with primary generalized or partial (with or without secondary generalization) tonic-clonic seizures, as well as in the complex therapy of seizures associated with Lennox-Gastaut syndrome;
• migraine: prevention of migraine attacks in adult patients after careful evaluation of all possible alternative therapies. Topsaver is not indicated for the treatment of acute migraine attacks.

Contraindications

Topsaver is contraindicated in case of hypersensitivity to any of the components of the antiepileptic drug.

Additional contraindications for tablets:

• age up to 3 years;
• pregnancy and lactation.

Additional contraindications for capsules:

• age up to 2 years for admission in monotherapy mode and as part of combined treatment of epilepsy; age up to 18 years when used for the prevention of migraines;
• lactase deficiency, lactose intolerance, glucose-galactose malabsorption.

It is contraindicated to take Topsaver capsules to prevent migraines in women of reproductive age who do not use reliable contraceptives.

Care should be taken to use both dosage forms of the drug for the following diseases:

• hepatic and / or renal failure;
• nephrourolithiasis (including indications of a history or family history);
• hypercalciuria.

Topsaver, instructions for use: method and dosage

Topsaver is taken orally, with or without food, with plenty of water. The tablet / capsule should be swallowed whole without chewing. If the patient has trouble swallowing the capsule, you can carefully open it and mix the contents with a small amount (about 1 teaspoon) of any soft food, and then swallow the prepared mixture without chewing. Do not store this mixture.

For optimal control of epileptic seizures, it is recommended to start therapy with the drug at low doses, followed by a stepwise increase to the most effective dose. In order to achieve the best result of therapy with topiramate, it is not necessary to control its plasma concentration.

Cancellation of Topsaver, like other antiepileptic drugs, is recommended gradually to minimize the risk of withdrawal symptoms or the likelihood of an increase in the number of seizures. If an urgent completion of drug therapy is required, it is recommended to stop taking it under medical supervision.

Monotherapy for epilepsy

In the case of cancellation of concomitant AEDs due to the transition to monotherapy with topiramate, it is necessary to take into account the aggravation of the threat of an increased frequency of seizures associated with this transition. If there is no need for the sudden cancellation of the previously used probes, it is recommended to reduce the dose of the latter gradually reducing it every 14 days on the ¹ / ₃. If these AEDs are inducers of liver microsomal enzymes, the plasma level of topiramate may increase; in such cases, it is recommended to reduce the Topsover dose according to an individual scheme.

Adults should start using 25 mg tablets / capsules at night for 7 days. Then the daily dose is gradually increased by 25/50 mg with an interval of 7-14 days and divided into 2 doses. If, with a rapid increase in the dose, the drug is poorly tolerated, it should be increased by a smaller amount or after longer periods of time. When carrying out monotherapy in adults with newly diagnosed epilepsy, the drug is usually prescribed in an initial daily dose of 100 mg, while the maximum dose should not exceed 500 mg per day, divided into 2 doses. It was noted that some patients with refractory forms of epilepsy tolerated Topsaver monotherapy in capsule form in daily doses up to 1000 mg.

In the case of monotherapy of epilepsy in children over 7 years old when prescribing tablets and in children over 2 years old when prescribing capsules, the recommended initial daily dose of Topsaver is 0.5–1 mg / kg per night for 7 days. Then, with an interval of 7-14 days, the daily dose is increased by 0.5-1 mg / kg, with a frequency of administration 2 times a day. If manifestations of intolerance are recorded, the time interval should be increased or the dose should be increased more gradually. The optimal dose and frequency of administration in children is established taking into account the therapeutic effect. When using Topsaver tablets, the recommended dose range is 3–6 mg / kg, when using capsules - 100–400 mg per day. Against the background of recently established partial seizures in children, a maximum daily dose of up to 500 mg is allowed.

Complex therapy of epilepsy

As part of complex therapy in adults, the minimum effective dose of Topsaver in the form of both capsules and tablets is 200 mg per day, the average daily dose is 200-400 mg, divided into 2 doses. Some patients require a single dose to achieve clinical effect when using capsules. Dose titration in adults begins with 25–50 mg 1 time per day at night for 7 days, then the dose is increased by 25–50 mg per day at intervals of 7–14 days, with a frequency of 2 times a day. If the drug is poorly tolerated with this dosing regimen, the dose is increased at large intervals or by less. The maximum daily dose should not exceed 1600 mg.

Children over 2 years old when taking capsules and children over 3 years old when taking Topsaver tablets are recommended to start with a dose of 25 mg taken before bedtime for 7 days, followed by its increase 1 time in 7-14 days by 1-3 mg / kg per day in 2 doses. The recommended daily dose in children is 5-9 mg / kg. As a rule, when using capsules, a daily dose of 30 mg / kg is well tolerated.

Prevention of migraine

Adults take Topsaver capsules before bedtime at an initial dose of 25 mg or less for 7 days, then the dose is increased with an interval of 7 days by 25 mg per day. In the event of intolerance to such a regimen, the dose is increased more smoothly or over a longer interval. In some cases, a positive result can be achieved while taking a daily dose of 50 mg. The use of doses exceeding 200 mg per day has not been studied.

Side effects

• mental disorders: very often - depression; often - insomnia, emotional lability, confusion, aggressiveness, disorientation, agitation, mood swings, bradifrenia; additionally for capsules - expressive speech, depressive mood, anger, pathological behavior; in children - aggressive reactions, abnormal behavior; infrequently - anxiety, sleep disorders, impaired reading skills, dysfemia, emotional lability, tearfulness, perseveration of thinking, auditory and visual hallucinations, apathy, agitation, lack of spontaneous speech, flattened affect, early awakening in the morning, euphoria, panic attacks, lethargy, distraction, suicidal thoughts / attempts, paranoid states, perseverations, pathological thinking, psychotic disorders; additionally for Topsaver tablets - hypomanic conditions;for capsules - intrasomnic disorder; rarely - a feeling of hopelessness / despair, mania; in children - crying, apathy;
• central nervous system (CNS): very often - dizziness, drowsiness, paresthesia; often - impaired memory / attention, impaired coordination / balance, cognitive impairment, tremor, nystagmus, seizures, intentional tremor, psychomotor disorders, amnesia, mental impairment, taste perversion, hypesthesia, sedation, apathy, lethargy, speech impairment; mental disorders (tablets): infrequently - awkwardness of movements, loss of gustatory sensitivity, increased salivation, burning sensation (mainly on the face and in the extremities), cerebellar syndrome, postural dizziness, dysgraphia, dysesthesia, dysphasia, dyskinesia, hypokinesia, aphasia, hypogeusia, repetitive speech, goosebumps, light-headedness, fainting, stupor, sensory disturbances; in children - psychomotor hyperactivity;additionally for tablets - impairment of touch, peripheral neuropathy; for capsules - parosmia, loss of visual field, inability to learn, peripheral neuropathy, depression of consciousness, aura, tonic-clonic seizures of the grand mal type, complex partial seizures; rarely - hyperesthesia, apraxia, anosmia, hyposmia, disturbance of circadian rhythms of sleep (in children), essential tremor, lack of response to stimuli, akinesia;
• digestive system: very often - diarrhea, nausea; often - dryness of the oral mucosa, constipation, vomiting, pain in the upper abdomen, dyspepsia, abdominal discomfort / pain, paresthesia of the oral mucosa, gastritis; infrequently - bad breath, bleeding gums, pain in the oral cavity, flatulence, lower abdominal pain, hypoesthesia of the oral mucosa, hypersecretion of the salivary glands, glossodynia, gastroesophageal reflex disease, pancreatitis, epigastric discomfort; additionally for capsules - pain on palpation of the abdomen;
• organ of vision: often - blurred / impaired vision, diplopia; infrequently - myopia, scotoma (including atrial fibrillation), decreased visual acuity, amblyopia, blepharospasm, presbyopia, mydriasis, photopsia, violation of accommodation; additionally for capsules - photophobia, discomfort in the eyes; rarely - transient blindness, night blindness, one-sided blindness, edema of the eyelids, in addition to tablets - increased lacrimation, dryness of the mucous membrane of the eyes; for capsules - glaucoma, impaired spatial perception; extremely rare (tablets) / unknown frequency (capsules) - impaired movement of the eyeballs, angle-closure glaucoma, maculopathy;
• blood and lymphatic system: often - anemia; infrequently - thrombocytopenia, leukopenia, lymphadenopathy, eosinophilia; extremely rare - neutropenia;
• infections: very rarely - nasopharyngitis;
• immune system: often (capsules) - hypersensitivity; infrequently (tablets) / unknown frequency (capsules) - conjunctival edema, allergic edema;
• hepatobiliary system (capsules): liver failure, hepatitis;
• cardiovascular system: infrequently - hot flushes, palpitations, arterial hypotension (capsules), bradycardia, orthostatic hypotension; rarely - Raynaud's phenomenon;
• organ of hearing and labyrinth disorders: often - ear pain, tinnitus, vertigo; infrequently - hearing impairment, discomfort in the ears, deafness, including sensorineural and unilateral;
• respiratory system: often - nasal congestion, rhinorrhea, shortness of breath, nosebleeds; infrequently - hypersecretion in the paranasal sinuses, dysphonia, shortness of breath on exertion; for capsules with an unknown frequency - cough;
• skin and subcutaneous tissues: often - alopecia, for tablets - skin rash and itching; infrequently - facial skin hypoesthesia, skin pigmentation disorders, macular rash, erythema, facial edema, generalized itching (tablets), allergic dermatitis (capsules); anhydraz, oligohydrosis (mainly in children); rarely - skin redness, periorbital edema, unpleasant skin odor, Steven-Johnson syndrome, acne (capsules), erythema multiforme (tablets); extremely rare - generalized edema; isolated cases (with an unknown frequency - for capsules) - toxic epidermal necrolysis;
• musculoskeletal system and connective tissue: often - muscle spasm, muscle cramps, muscle weakness, arthralgia, myalgia (including in the chest); infrequently - muscle fatigue, musculoskeletal stiffness, pain in the side, swelling of the joints; rarely - discomfort in the limbs, discomfort in the lumbar region (pills);
• urinary system: often - pollakiuria, dysuria, nephrolithiasis; infrequently - urinary incontinence (including stress), frequent urge to urinate, hematuria, pain in the kidney, renal colic, urolithiasis; rarely - renal tubular acidosis, ureteral calculi;
• reproductive system: infrequently - sexual dysfunction, erectile dysfunction;
• metabolism and malnutrition: often - decreased appetite, anorexia; infrequently - increased appetite, metabolic acidosis, hypokalemia, polydipsia; rarely - hyperchloremic acidosis;
• laboratory and instrumental data: very often - weight loss; often - weight gain; infrequently - crystalluria, additionally for capsules - a decrease in the number of blood leukocytes, an abnormal result of the tandem gait test, increased activity of liver enzymes; rarely - a decrease in the plasma level of bicarbonates in the blood;
• others: very often - fatigue; often - asthenia, fever, malaise; infrequently - flu-like syndrome, cold extremities, thirst; additionally for capsules - feeling of intoxication, hyperthermia; rarely - calcification.

Overdose

Symptoms of a Topsavera overdose may include the following reactions: drowsiness, dizziness, lethargy, agitation, stupor, depression, convulsions, diplopia, visual impairment, speech disorder, impaired coordination, impaired thinking, abdominal pain, and decreased blood pressure. Clinical consequences, as a rule, were not severe, however, deaths were recorded after an overdose with the combined use of several drugs, including topiramate. An overdose of the latter can provoke the occurrence of severe metabolic acidosis, in children - hyperchloremic acidosis.

If an overdose is suspected, if the patient ate food shortly before taking an excessive dose of Topsaver, it is necessary to immediately flush the stomach or induce vomiting. According to in vitro studies, activated carbon can adsorb topiramate. If necessary, the appointment of symptomatic therapy is recommended. It has been found that topiramate is effectively excreted from the body through hemodialysis. Fluid intake should be adequately increased.

special instructions

In some patients, mainly with a predisposition to nephrolithiasis and hypercalciuria, the use of Topsaver may aggravate the threat of renal stones formation, accompanied by such phenomena as pain in the kidney and side, and renal colic. During treatment with the drug, adequate hydration is of great importance, which is necessary to reduce the threat of nephrolithiasis.

In conditions of high ambient temperatures, when using the product, especially in young children, hyperthermia and decreased sweating may occur. Adequate fluid replacement prior to and during exercise and during exposure to elevated temperatures can significantly reduce the risk of overheating-related complications.

While taking Topsaver, it is necessary to monitor the condition of patients in order to identify suicidal thoughts and / or suicidal behavior. If signs of suicidal idealization are found, it is necessary to decide on the appropriate treatment. Patients, as well as persons caring for them, should immediately inform the attending physician about the appearance of such conditions. In the presence of any personality disorder, patients need careful monitoring, especially at the beginning of the drug intake.

During therapy with Topsaver, the appearance of acute myopia associated with angle-closure glaucoma may occur. Symptoms of this complication may include eye pain and / or decreased visual acuity. When conducting an ophthalmological examination, it is possible to detect such disorders as flattening of the anterior chamber of the eye, myopia, hyperemia of the eyeball, increased intraocular pressure, and the development of mydriasis is also likely. The symptom complex may be accompanied by the production of fluid that causes displacement of the lens and iris, with the occurrence of secondary angle-closure glaucoma. The development of these symptoms is expected one month after the start of the course of treatment. If violations are detected on the part of the organ of vision, including a symptom complex, which includes acute myopia with concomitant angle-closure glaucoma, the attending physician should, if permissible,cancel therapy with topiramate and take appropriate measures aimed at lowering intraocular pressure. It should be borne in mind that increased intraocular pressure of any genesis in the absence of proper treatment can cause serious complications, including loss of vision.

During treatment, hyperchloremic metabolic acidosis, not associated with anion deficiency, may develop, for example, a decrease in the plasma concentration of hydrocarbons, which does not reach normal levels in the absence of respiratory alkalosis. This decrease in the content of bicarbonates in the blood serum is due to the inhibitory effect of topiramate on renal carbonic anhydrase and is observed in most cases at the beginning of the use of the drug. To prevent the appearance of metabolic acidosis during therapy, appropriate studies should be carried out, including to determine the serum concentration of hydrocarbons. If metabolic acidosis develops and persists, you should stop taking Topsaver or reduce its dose. The presence of chronic metabolic acidosis increases the risk of nephrolithiasis,and in children it can cause a slowdown in the growth rate. The effect of topiramate on growth and the occurrence of possible complications associated with the skeletal system in children and adults has not been systematically studied.

If during treatment the patient's body weight decreases, it is necessary to adjust the diet.

While taking Topsaver, you should avoid drinking ethanol-containing drinks.

You cannot use the drug simultaneously with other drugs that have a depressing effect on the central nervous system.

Influence on the ability to drive vehicles and complex mechanisms

During the period of therapy, it is recommended to be careful when driving vehicles and other complex and potentially dangerous mechanisms, due to the possible development of visual impairments, drowsiness, dizziness and other undesirable phenomena from the central nervous system.

Application during pregnancy and lactation

There have been no strictly controlled and adequate clinical studies proving the efficacy and safety of Topsaver during pregnancy.

The use of topiramate during pregnancy can cause the development of pathologies in the fetus. According to the data of the register of pregnant women, with intrauterine exposure to the substance on the fetus, the risk of congenital malformations (craniofacial defects, hypospadias and others) is aggravated. These malformations were registered when the drug was used in monotherapy mode and when it was included in the combination treatment.

Prescribing topiramate for the treatment of epilepsy in women of childbearing age is allowed only when the expected benefits of therapy greatly outweigh the possible risks. If Topsaver is used during pregnancy or in the case when pregnancy occurred during treatment, the patient should be informed of the potential threat to the fetus.

Patients with preserved childbearing potential during the period of therapy should use sufficiently reliable contraceptives.

It is contraindicated to use Topsaver for the prevention of migraine in women of reproductive age who do not use adequate contraception.

Since it is assumed that topiramate may be excreted in breast milk, breastfeeding should be discontinued if Topsaver is required during lactation.

Pediatric use

Children under 3 years old are contraindicated to take Topsaver in the form of tablets, taking this form in children after 3 years is allowed according to the dosage regimen.

Children under 2 years old are contraindicated in taking the drug in the form of capsules when used as a means of monotherapy and as part of complex therapy for epilepsy.

In order to prevent migraine, Topsaver is not used in pediatric practice.

With impaired renal function

In the presence of functional impairment of the kidneys, Topsaver should be used with caution.

Patients with moderately [creatinine clearance (CC) below 70 ml / min] and severely (CC below 30 ml / min) severe renal impairment may take 10-15 days to achieve C _ss, as opposed to 4-8 days required for normal kidney function. As with other patients, the dose should be increased gradually in accordance with the results of therapy. The initial recommended dose must be reduced by 2 times, and then increased at longer than usual intervals or more gradually.

Since Topsaver can be eliminated by hemodialysis, patients on hemodialysis treatment should increase the daily dose of the drug by 50% on the days of it. It is necessary to enter an additional dose in parts - before the start of the session and after its completion. The dose is selected taking into account the clinical effect, as well as the characteristics of dialysis and the equipment used for its implementation.

For violations of liver function

In the presence of violations of the liver, Topsaver should be used with extreme caution due to a possible decrease in the clearance of topiramate.

Use in the elderly

Elderly patients with normal renal function do not require Topsover dose adjustment.

Drug interactions

• carbamazepine, phenytoin: the plasma concentration of topiramate in the blood decreases, which is due to the induction of enzymes involved in the metabolism of the latter; in some cases, an increase in plasma phenytoin levels is possible; when adding or canceling these funds, the dose of topiramate should be adjusted;
• digoxin: AUC decreases after taking a single dose of this substance in combination with a single dose of topiramate;
• oral contraceptives containing ethinyl estradiol and norethindrone: the clearance of norethindrone is not significantly affected, while the plasma clearance of ethinyl estradiol is significantly increased, which can lead to a decrease in the effectiveness of these oral contraceptives; when using these drugs as part of a combination treatment, it is necessary to inform a specialist about any changes in the nature of menstruation;
• metformin: there is an increase in the average values of its C _max and AUC by 18 and 25%, respectively, and a decrease in the average value of the total clearance by 20%; the clinically significant effect of metformin on the pharmacokinetic parameters of topiramate has not been determined;
• hydrochlorothiazide: an increase in C _max and AUC of topiramate by 27 and 29%, respectively, is recorded, which may require adjustment of its dose;
• lithium preparations: there is an increase in AUC and C _{max of} lithium by 26 and 27%, respectively, while taking topiramate in doses up to 600 mg per day; monitoring of the concentration of lithium in the blood is required;
• drugs that predispose to the development of nephrolithiasis (triamterene, acetazolamide, ascorbic acid in a daily dose above 2000 mg): the threat of kidney stones is aggravated; such combinations should be avoided;
• glibenclamide, pioglitazone, metformin: fluctuations in plasma glucose concentration may be observed, blood glucose levels should be monitored.

Analogs

Topsavera's analogues are Maxitopyr, Topamax, Ropimat, Topiramat, Epimax, Topiromax, Toreal, Epitop, Torepimat, Topalepsin.

Terms and conditions of storage

Store in a place protected from moisture and light, out of reach of children, at a temperature not exceeding 25 ° C.

Shelf life of tablets - 3 years, capsules - 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Topsaver

On medical websites and specialized forums, reviews about Topsaver are mostly positive. Patients and their relatives note the effectiveness of the drug in the treatment of epileptic seizures. When choosing the optimal dose of the drug, many patients managed to achieve remission of the disease or reduce the frequency of epileptic seizures.

At the same time, there are also reviews in which they indicate the poor tolerance of drug therapy in comparison with treatment with its analogues. Some patients point to the high cost of this antiepileptic drug as a disadvantage.

Topsaver price in pharmacies

Depending on the form of release and dosage, the price for Topsaver can be:

• film-coated tablets (28 pcs. in a package): dosage 25 mg - 300-450 rubles; dosage 50 mg - 500-600 rubles; dosage of 100 mg - 1300-1600 rubles;
• capsules (60 pcs. per package): dosage 25 mg - 1550 rubles.

Topsaver: prices in online pharmacies

Drug name Price Pharmacy

Topsaver 25 mg film-coated tablets 28 pcs. 169 RUB Buy

Topsaver 50 mg film-coated tablets 28 pcs. 259 r Buy

Topsaver tablets p.p. 50mg 28 Pcs. 546 r Buy

Topsaver 100 mg film-coated tablets 28 pcs. 1259 RUB Buy

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!