For Healthcare Professionals
TOPAMAX is Efffective in Partial-Onset and Primary
Generalized Tonic-Clonic Seizures1
Kaplan-Meier Estimates of Cumulative Rates for Time to First Seizure1
Across Seizure Types in Adults and Children
In primary generalized tonic-clonic seizures, TOPAMAX demonstrated a clinically significant response
in seizure reduction. Fifty-seven percent of patients treated with TOPAMAX achieved a 50% or higher
reduction in seizure rate compared to 9% for placebo-treated patients.2
Primary Generalized Tonic-Clonic Seizures in Adults and Children2,3
Studies in adults and children with partial-onset seizures demonstrated TOPAMAX was effective in
reducing seizure rates compared to placebo.4,5
Partial-Onset Seizures in Adults4

Partial-Onset Seizures in Children 2 to 16 Years of Age5
Early Onset of Effect—Low Target Dose4
TOPAMAX 200 mg/day is an initial appropriate target dose. The therapeutic effect of TOPAMAX can
be seen as early as 2 weeks into therapy. In addition, TOPAMAX dosed at 200 mg/day in patients with
refractory partial-onset seizures was effective as adjunctive therapy when added to enzyme-inducing
AEDs. This rapid onset of effect and low target dose offer a distinct benefit to patients and professionals
alike.4
Onset of Effect During Titration4

Demonstrated Seizure Reduction Across Seizure Types in Adults and Children
In controlled clinical trials, TOPAMAX has been effective in reducing monthly seizure rates by at
least 50% in 57% of patients with primary generalized tonic-clonic seizures.2,3
An analysis of a study in adults with partial-onset seizures indicates that patients may notice
a beneficial effect on seizures early—as early as 2 weeks.
Primary Generalized Tonic-Clonic Seizures in Adults and Children2,3

After 16 weeks of TOPAMAX therapy, 44% of adults with partial-onset seizures had their monthly seizure
rate reduced by at least 50%.3,6
Partial-Onset Seizures in Adults3,6

After 16 weeks of TOPAMAX therapy, 39% of children with partial-onset seizures achieved a ≥ 50%
reduction in their monthly seizure rate.3,5
Partial-Onset Seizures in Children 2 to 16 Years of Age3,5

In their monthly rate of drop attack seizures, 28% of patients with Lennox-Gastaut syndrome achieved
a 50% or greater reduction in seizure frequency from baseline with TOPAMAX.3,7
Drop Attacks Associated With Lennox-Gastaux Syndrome3,7

References:
- Arroyo S, Dodson WE, Privitera MD, et al, for the EPMN-106/INT-28 Investigators. Randomized dose-controlled study of topiramate as first-line therapy in epilepsy. Acta Neurol Scand. 2005;112:214-222.
- Biton V, Montouris GD, Ritter F, et al, and the Topiramate YTC Study Group. A randomized, placebo-controlled
study of topiramate in primary generalized tonic-clonic seizures. Neurology. 1999;52:1330-1337.
- Data on file, Ortho-McNeil Neurologics, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
- Guberman A, Neto W, Gassmann-Mayer C, and the EPAJ-119 Study Group. Low-dose topiramate in adults
with treatment-resistant partial-onset seizures. Acta Neurol Scand. 2002;106:183-189.
- Elterman RD, Glauser TA, Wyllie E, et al, and the Topirmate YP Study Group. A double-blind, randomized
trial of topiramate as adjunctive therapy for partial-onset seizures in children. Neurology.
1999;52:1338-1344.
- Faught E, Wilder BJ, Ramsay RE, et al, and the Topiramate YD Study Group. Topiramate placebo-controlled
dose-ranging trial in refractory partial epilepsy using 200-, 400-, and 600-mg daily dosages. Neurology.
1996;46:1684-1690.
- Sachdeo RC, Glauser TA, Ritter F, et al, and the Topiramate YL Study Group. A double-blind, randomized
trial of topiramate in Lennox-Gastaut syndrome. Neurology. 1999;52:1882-1887.
About TOPAMAX®
TOPAMAX® is indicated as initial monotherapy in patients 10 years of
age and older with partial-onset or primary generalized tonic-clonic
seizures.
Effectiveness was demonstrated in a controlled trial in patients with
epilepsy who had no more than 2 seizures in the 3 months prior to
enrollment. Safety and effectiveness in patients who were converted to
monotherapy from a previous regimen of other anticonvulsant drugs have
not been established in controlled trials.
TOPAMAX® is indicated as adjunctive therapy for patients 2 years of age
and older with primary generalized tonic-clonic seizures,
partial-onset seizures, or seizures associated with Lennox-Gastaut
syndrome.
Important Safety Information
TOPAMAX® has been associated with serious adverse events including:
-
acute myopia and secondary angle-closure glaucoma-patients should
seek medical attention if they experience blurred vision or ocular
pain
-
oligohidrosis and hyperthermia-occurs most often in hot weather and
in children
-
hyperchloremic, non-anion gap metabolic acidosis (lowering of serum
bicarbonate levels)-measurement of baseline and periodic serum
bicarbonate levels is recommended
-
cognitive/psychiatric side effects including somnolence, fatigue,
cognitive dysfunction, and psychiatric/behavioral disturbances
including suicidal thoughts or behavior
-
hyperammonemia with or without encephalopathy-associated with the
concomitant use of valproic acid; and kidney stones-patients should
maintain an adequate fluid intake to minimize the risk of renal stone
formation.
Antiepileptic drugs (AEDs); including TOPAMAX® increase the risk of
suicidal thoughts or behavior in patients taking these drugs for any
indication. Patients treated with any AED for any indication should be
monitored for the emergence or worsening of depression, suicidal
thoughts or behavior, and/or any unusual changes in mood or behavior.
There are no adequate and well-controlled studies using TOPAMAX® in
pregnant women. Pregnancy registry data suggest that there may be an
association between the use of TOPAMAX® during pregnancy and
congenital malformations (e.g., craniofacial defects, such as cleft
lip/palate, hypospadias, and anomalies involving various body
systems). This has been reported with topiramate monotherapy and
topiramate as part of a polytherapy regimen.
Physicians are advised to recommend that pregnant patients taking
TOPAMAX® enroll in the NAAED Pregnancy Registry by calling
1-888-233-2334.
As monotherapy, the most common side effects of TOPAMAX® (in the 400
mg/day group and at a rate higher than the 50 mg/day group) in adults
were: paresthesia, weight decrease, somnolence, anorexia,* dizziness,
and difficulty with memory; and in children: weight decrease, upper
respiratory tract infection, paresthesia, anorexia, diarrhea, and mood
problems.
In combination with other antiepileptic drugs (AEDs), the most common
side effects of TOPAMAX® in adults (dosed at 200 to 400 mg/day) were:
somnolence, dizziness, nervousness, ataxia, fatigue, speech disorders
and related problems, psychomotor slowing, abnormal vision, difficulty
with memory, paresthesia, and diplopia; and in children (dosed at 5 to
9 mg/kg/day): fatigue, somnolence, anorexia, nervousness, difficulty
with concentration/attention, difficulty with memory, aggressive
reaction, and weight decrease.
In women taking combination oral contraceptives with TOPAMAX®, a
significant decrease in estrogen exposure has been shown at TOPAMAX®
doses >200 mg/day. The possibility of decreased contraceptive efficacy
and increased breakthrough bleeding should be considered.
*Anorexia is defined as loss of appetite.
You are encouraged to report negative side effects of prescription
drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see
full U.S. Prescribing
Information.
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This site was last modified on: Apr 29 2008 at 16:11:27 EDT