may decrease effect of oral contraceptives especially with high doses 200mgday

May decrease effect of oral contraceptives especially

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may decrease effect of oral contraceptives especially with high doses (> 200mg/day) Dosage Forms Capsule ER sprinkle, extended-release capsule, capsule sprinkle, tablet Dose CrCl <70 ml/min: reduce dose by 50% 64 FDA Approval Date December 24, 1996
Topiramate Adult Dosing Pediatric Dosing Titrated weekly Week1: 25mg BID (IR) or 50mg daily (XR) Week 2: 50mg BID (IR) or 100mg daily (XR) Week 3: 75mg BID (IR) or 150mg daily (XR) Week 4: 100mg BID (IR) or 200mg daily (XR) Increase dose by 100mg weekly until max dose or therapeutic effect Max dose: 400mg/day Monotherapy, Partial-onset seizure & primary generalized tonic-clonic seizure Children 2 to <10 years: Oral IR Initial: 25 mg once daily (in evening); may increase to 25 mg twice daily in week 2; thereafter, may increase by 25 to 50 mg daily at weekly intervals over 5 to 7 weeks up to the following minimum recommended maintenance dose: ≤11 kg: 150 mg daily in 2 divided doses 12 to 22 kg: 200 mg daily in 2 divided doses 23 to 31 kg: 200 mg daily in 2 divided doses 32 to 38 kg: 250 mg daily in 2 divided doses ≥39 kg: 250 mg daily in 2 divided doses Weight based dosing! Children 6 to <10 years: Oral: Extended release Trokendi XR only Children ≥10 years and Adolescents: Refer to adult dosing 65 *Topamax sprinkle capsule: may be swallowed whole or opened to sprinkle the contents on a small amount (~1 tsp) of soft food; do not chew drug/food mixture; swallow immediately
Medication Coaster!!!! 66 - clipart.png Start End Ke pp ra ® LaMICtal ® TEGretol® Tril ep t al ® Depacon® Dila ntin® Cereb y To pamax® Lyr ica® Pheno barbit al Z aront in ® Vimpa t ® Ne urontin ® Other AEDs
GABA Analogues Pregabalin (Lyrica ®) & Gabapentin (Neurontin ®) Drug Pregabalin Gabapentin Schedule C-V RX Mechanism of Action (MOA) Bind to the alpha-2-delta subunit of voltage-dependent calcium channels w/in the CNS, inhibiting excitatory neurotransmitter release Safety/Side Effects/Monitori ng Side effects  Dizziness, somnolence, peripheral edema, weight gain, ataxia, diplopia, blurred vision, dry mouth, mild euphoria (pregabalin only) Monitor  weight gain and edema Drug Interactions Caution use with glitazones due to risk of additive edema Dosage Forms Capsule, solution Capsule, tablet, solution Dose Adjustments CrCl <60 ml/min: decrease dose and/or extend interval 67 Lyrica: FDA Approval Date December 30, 2004 Neurontin: FDA Approval Date December 30, 1993 Note: often used in neuropathic pain
Barbiturates Phenobarbital & Primidone (Myosline ®) Drug Phenobarbital Primidone (Prodrug of Phenobarb) Schedule C-IV RX Mechanism of Action (MOA) Enhance GABA-mediated Cl influx; shift in Cl- ions results in hyperpolarization (a less excitable state) and membrane stabilization Safety/Side Effects/Monitorin g Contraindicated  marked hepatic impairment, dyspnea or airway obstruction, subcutaneous administration Side effects  somnolence, cognitive impairment, tolerance, dependence, hangover effect, depression, Vitamins D & calcium deficiency (bone loss) Monitor  LFTs, CBC w/ differential, serum drug concentrations Therapeutic range

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