Topiramate is absorbed quickly and efficiently. Its bioavailability is 81%. Food intake has no clinically significant effect on the bioavailability of topiramate. Since plasma protein binds to 13-17% of topiramate.After receiving a single dose of 1200 mg the average volume of distribution is 0,55-0,8 l / kg. The anti estrogen pills value of volume of distribution depends on sex: for women it is about 50% of the values observed in men, which is associated with higher levels of body fat women.
After oral administration, it is metabolized about 20% of the dose. However, in patients receiving concomitant therapy with antiepileptic drugs that induce the enzymes responsible for drug metabolism, the metabolism of topiramate is increased to 50%. Six virtually inactive metabolites have been isolated and identified from the plasma, urine and human faeces. The main route of excretion of unchanged topiramate (70%) and its metabolites are the kidneys. Following oral administration of topiramate plasma clearance is 20-30 ml / min. The pharmacokinetics of topiramate is linear, plasma clearance remains constant anadrol, and the area under the curve “concentration-time» anti estrogen pills in the dose range from 100 to 400 mg increases proportionally with dose. In patients with normal renal function in order to achieve stable plasma concentrations may need 4 to 8 days. The value of maximum concentration after repeated oral administration of 100 mg twice a day averaged 6.76 ug / ml. After receiving multiple doses of 50 and 100 mg twice a day half-life of plasma topiramate averaged 21 hour.
In patients with impaired renal function, moderate and severe plasma and renal clearance of topiramate is reduced as a consequence may increase the equilibrium concentration of topiramate in plasma when compared with patients having normal renal function. In addition, in patients with impaired renal function, it takes longer to reach equilibrium concentration of topiramate in the blood. Patients with moderate or severe renal insufficiency is recommended to use half the recommended initial and maintenance dose.
Topiramate effectively derived from the plasma by hemodialysis. Long term hemodialysis may reduce the concentration of topiramate in the blood below the quantity required anastrozole bodybuilding to maintain the anticonvulsant activity. To avoid rapid fall topiramate plasma concentration during hemodialysis, may require the appointment of an additional dose of the drug Topamax ®. When dose adjustment should be taken into account:
- dialysis duration,
- the value of clearance anti estrogen pills used hemodialysis systems,
- effective renal clearance of topiramate in patients on dialysis.
Plasma clearance of topiramate is reduced by an average of 26% in patients with hepatic insufficiency, moderate or severe. Therefore, patients with hepatic impairment topiramate should be used with caution.
In elderly patients without renal disease, the plasma clearance of topiramate is unchanged.
The pharmacokinetics of topiramate in children up to 12 years
The pharmacokinetic parameters of topiramate in children as well as adults receiving this drug as an adjunct therapy, are linear, while its ground clearance is independent of dose, and the equilibrium concentration in the plasma increases proportionally to increasing doses. It should be noted, however, that the clearance of topiramate in children increased, and the period of its half-life is shorter.Consequently, anti estrogen pills for the same dose per 1 kg of body weight anavar only cycle, the plasma concentrations of topiramate in children may be lower than in adults. In children as in adults, antiepileptic drugs that induce liver enzymes cause a reduction in the plasma concentrations of topiramate. bodybuilding coupon code 10
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