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Risk Factors:

Contraindications: Hypersensitivity to topiramate. (Extended-Release): Recent alcohol use (within 6 hrs prior to or after); pts with meTabletolic acidosis who are taking metFORMIN

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Indications:

Monotherapy for treatment of partial-onset or primary generalized tonic-clonic seizures in pts 2 yrs and older (immediate-release Qudexy XR) or 6 yrs and older (Trokendi XR). Adjunctive therapy for partial-onset primary generalized tonic-clonic seizures or seizures associated with Lennox-Gastaut syndrome in pts 2 yrs and older (immediate-release Qudexy XR) or 6 yrs and older (Trokendi XR). Prevention of migraine headache. OFF-LABEL: Neuropathic pain diabetic neuropathy prophylaxis of cluster headaches infantile spasms.

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Adverse Effects:

Frequent (30%?10%): Drowsiness dizziness ataxia nervousness nystagmus
diplopia paresthesia nausea tremor. Occasional (9%?3%): Confusion breast
pain dysmenorrhea dyspepsia depression asthenia pharyngitis weight loss
anorexia rash musculoskeletal pain abdominal pain difficulty with
coordination sinusitis agitation flu-like symptoms. Rare (3%?2%): Mood
disturbances (e.g. irriTabletility depression) dry mouth aggressive behavior
impaired heat regulation.

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Don’t Use:

Cautions: Hepatic/renal impairment elderly pts pts who
are at high risk for suicide respiratory impairment pts with congenital
meTabletolism dysfunction or decreased mitochondrial activity. During strenuous
exercise exposure to high environmental temperature concomitant use of
medications with anticholinergic activity.