In the study in animals found no effect of topiramate on fertility. The effect of topiramate against fertility in humans is not installed. In renal and liver failure, nefrourolitiaze what is tamoxifen(including past and family history), hypercalciuria.
Dosing and Administration
Inside, regardless of meals. it is recommended to start treatment with low-dose formulation followed by a gradual titration to an effective dose to achieve optimal control of epileptic seizures in children and adults.
The capsules are designed for patients who have difficulty swallowing tablets (for example, children and elderly patients).
Capsules should be carefully opened, mix the contents of the capsules with a small amount (about 1 teaspoon) of a soft food. This mixture should be swallowed immediately without chewing. Do not store the medication, mixed with the food until the next reception.
Capsules what is tamoxifen can be swallowed whole.
Use in combination with other anticonvulsants in adult patients
The minimum effective dose is 200 mg per day. Typically, the total daily dosage is from 200 mg to 400 mg, and is received in two steps. Some patients may need to increase the daily dose to the maximum – 1600 mg. It is recommended to begin treatment with a low dose with a gradual selection of effective dose. Selection of doses begin with 25-50 mg, taking them at night for 1 week. Subsequently, at weekly or biweekly intervals can be increased at a dose of 25-50 mg and take it into two steps. In the selection of dose should be guided by clinical effect. In some patients, the effect can be achieved by taking the drug one time per day. To achieve the optimal effect of treatment with what is tamoxifenis not necessarily monitor its concentration in plasma.
The recommendations for dose apply to all adult patients, including the elderly, in the absence of their kidney disease .
Combined anticonvulsant therapy in children older than 2 years
The recommended total daily dose of the as adjunctive therapy agent is from 5 to 9 mg / kg and is received in two steps. Titration should begin with 25 mg (or less based on the initial dose of 1 to 3 mg / kg per day), taking them at night for one week. Subsequently, at weekly or biweekly intervals dose can be increased to 1 – 3 mg / kg and to take it into two steps. In the selection of dose should be guided by clinical effect. The daily dose of 30 mg / kg is generally well tolerated.
Epilepsy (including newly diagnosed)
Monotherapy: general provisions
If you cancel the related anticonvulsants topiramate monotherapy for the purpose it is necessary to take into account the possible impact of this step on the frequency of seizures. In cases where there is no need to sharply cancel accompanying anticonvulsants for security reasons, it is recommended to reduce their dose gradually reducing the dose of concomitant antiepileptic drugs by what is tamoxifen one-third every 2 weeks.
If you cancel the drugs that are inducers of microsomal liver enzymes, will increase topiramate concentration in the blood . In such situations, if clinically indicated drug dose Topamax ® can be reduced.