Side effects of neurological and psychiatric disorders: anxiety, dizziness, headache, disturbances of speech and vision, psychomotor retardation, ataxia, fatigue, concentration difficulties of attention, confusion, paresthesia, drowsiness, abnormal thinking, diplopia, anorexia, nystagmus, depression, perversion taste sensation, arousal, cognitive impairment, emotional lability, apathy, psychotic symptoms, aggressive behavior, suicidal ideation or attempts; additional children – personality disorder, increased salivation, hyperkinesia, hallucinations. Gastrointestinal disorders: dyspepsia, nausea, abdominal pain, diarrhea, dry mouth, increased activity of “liver” transaminases, hepatitis, liver failure.

On the part of the eye: may undecanoate cause myopia syndrome accompanied by increased intraocular pressure, a sharp decline in visual acuity and pain in the eyes. Myopia, reducing the depth of the anterior chamber of the eye, eye redness of the mucous membrane and increased intraocular pressure, mydriasis. A possible mechanism for these violations oxandrolone for sale is to increase supratsiliarnogo effusion that leads to a shift forward of the lens and iris, and as a consequence – the development of secondary angle-closure glaucoma. Skin and mucous membranes: erythema multiforme, pemphigus, Stevens-Johnson syndrome and toxic epidermal necrolysis Other: reduction body weight, leukopenia, nephrolithiasis, oligogidroz (mainly in children), metabolic acidosis.

Overdose symptoms: convulsions, disturbance of consciousness up to coma, decreased blood pressure, severe metabolic acidosis, increased severity of side effects. Treatment: gastric lavage, activated charcoal, symptomatic therapy, hemodialysis.

Interaction with other drugs Effect of topiramate on other does not affect the concentration of carbamazepine, valproic acid, phenobarbital, primidone. In some cases, when used with phenytoin, may increase phenytoin plasma concentrations. The effect of topiramate on other When the joint application of topiramate to phenytoin and carbamazepine may decrease plasma concentrations of topiramate, thus with the addition or withdrawal of phenytoin or carbamazepine is recommended that dose adjustment of topiramate. When receiving otherundecanoatethat induce liver enzymes, reduced the maximum concentration of topiramate in plasma. Other interactions Digoxin: AUC (area under the curve “concentration-time”) of digoxin is reduced by 12%. oral contraceptives: topiramate at a dose of 50-800 mg / day had no significant effect on efficacy and norethindrone in a dose of 50-200 mg / day – the efficiency of ethinyl estradiol. Significant dose-dependent decrease in efficiency was observed when receiving ethinylestradiol topiramate at a dose of 200-800 mg / day. Patients taking oral contraceptives should tell your doctor uk muscle about any changes in bleeding patterns. Metformin: In an application with topiramate the mean value of the maximum concentration and AUC (area under the curve “concentration-time”) of metformin increased by 18% and 25%, respectively, while the average total clearance is reduced by 20%. Topiramate does not affect the time of the vehicle to achieve

metformin. Plasma clearance of topiramate is reduced under the influence of metformin. The clinical significance of effects of metformin on the pharmacokinetics of topiramate is unclear. The appointment or termination of topiramate on metformin therapy is necessary to monitor the status of carbohydrate metabolism. Hydrochlorothiazide: while admission is an increase in the maximum topiramate concentration (area under the curve “concentration-time”) of topiramate by 29%. The means depressing the central nervous system undecanoate: not recommended for concomitant use with topiramate ethanol and other means depressants. Pioglitazone: _vyyavleno decrease in (area under the curve “concentration-time”) of pioglitazone by 15%, without changing the maximum concentration of the drug. For active gidroksimetabolita pioglitazone showed a reduction in the maximum under the concentration curve concentration and area by 13% and 16%, respectively, and for the active ketometabolita and showed a reduction in the maximum concentration and AUC (area under the curve “concentration-time”) by 60%. The clinical significance of these data is unknown. Other facilities: Topiramate, when used dianabol in conjunction with other agents predisposing to nephrolithiasis, in particular carbonic anhydrase inhibitors (acetazolamide) may increase the risk of nephrolithiasis. During use of topiramate patients should avoid taking such drugs, as they can establish the physiological conditions that increase the risk of formation of kidney stones.

Special instructions: Before the drug for women is recommended to use adequate contraception. Topiramate, as well as other undecanoate, it is recommended to cancel, gradually reducing the dose, in order to reduce the potential risk of increased frequency of seizures. Renal impairment: Patients with moderate and severe strongly impaired renal function may need 10-15 days to reach equilibrium concentration in plasma as opposed to 4 -8 days for patients with normal renal function. As with all patients, a gradual increase in dose should be administered in accordance with clinical outcomes (such as the control of seizures, frequency of side effects), given that patients with moderate or severe renal impairment may require a longer time to reach steady-state after each dose. Nephrolithiasis : some patients, especially predisposed to nephrolithiasis, may increase the risk of forming kidney stones, accompanied by symptoms such as renal colic, pain in the side and in the kidney area. It is recommended that adequate hydration to reduce the risk of kidney stones. Hepatic impairment: in patients with hepatic impairment, topiramate clearance function is reduced. Myopia and secondary angle-closure glaucoma: in myopia development, it is recommended to cancel the topiramate as rapidly as is clinically possible and take measures to reduce intraocular pressure. metabolic acidosis: the application of topiramate may hyperchloraemic not associated with a deficit of anions, metabolic acidosis (e.g., reduction in the plasma concentration of hydrocarbons below the normal level in the absence of respiratory alkalosis). This reduction in the concentration of hydrocarbons serum is a consequence of the inhibitory effect of topiramate on renal carbonic anhydrase. In this regard, the treatment of topiramate recommended to periodically determine the concentration of bicarbonates in the blood serum.

Diet: with a decrease in body undecanoate weight during treatment topiramate is useful to consider the possibility of appointing an additional power supply. During treatment advised to refrain from driving and work requiring high concentration and quickness psychomotor reactions.