Atomax 25 mg (Topiramate)

Adult dose

It is preferable to start this medicine at a low dose and increase it to the effective dose. Monitoring blood concentrations is not necessary to optimize the dosage of this medicine. For adults, including older adults, without renal disease, the recommended dose applies. This medicine may be taken with or without food. Tablets should be swallowed whole and not crushed. Epilepsy monotherapy, adults (17 years and older): Start with 25㎎ in the evening for the first week. Thereafter, increase the daily dose by 25 or 50㎎ at 1- to 2-week intervals and administer in 2 divided doses. If the patient has difficulty tolerating this titration schedule, extend the interval between dose increases. The dose and titration rate should be determined according to clinical response. The recommended dose for adult monotherapy is 100～200mg daily. The maximum recommended dose is 500㎎ daily. Some patients with recurrent epilepsy have tolerated up to 1,000㎎ daily during topiramate monotherapy. Epilepsy adjunctive therapy, adults (17 years and older): The minimum effective dose is 200mg daily, and the usual dose is 200-400mg daily in 2 divided doses. Depending on the patient, the dose may be increased up to the maximum recommended dose of 800mg daily. Start treatment with 25-50mg in the evening during the first week; treatment may also be initiated at a lower dose. Thereafter, increase the dose by 25-50mg at 1- to 2-week intervals and administer in 2 divided doses. If the patient has difficulty tolerating dose increases, smaller increments may be used or the interval between increases may be extended. The dose should be determined according to clinical effect. Prevention of migraine, adults: Start with 25mg of this medicine in the evening for the first week. Thereafter, increase the dose by 25mg/day at weekly intervals. If the patient has difficulty tolerating these increases, extend the interval between increases. The recommended dose is 100mg daily, administered in 2 divided doses. Some patients may respond to a dose of 50mg daily. Doses of up to 200mg daily may be administered; the dose and titration rate should be determined according to clinical response. Patients with renal impairment: For patients with moderate or severe renal impairment (CLcr < 70 mL/min/1.73 m2), reducing the starting and maintenance doses to approximately 1/2 is recommended. Patients on hemodialysis: Since this medicine is removed from plasma by hemodialysis, increase the dose by approximately 1/2 on dialysis days. The dose should be increased taking into account the duration of dialysis, dialyzer clearance, and the patient's renal clearance, and divided between the start and end of hemodialysis. Administer with caution in patients with hepatic impairment, as clearance of this medicine may be reduced.

Child dose

Epilepsy monotherapy, children (6-16 years): Start with 0.5-1㎎/㎏ in the evening during the first week. Thereafter, increase the daily dose by 0.5-1㎎/㎏ at 1- to 2-week intervals and administer twice daily. If the patient has difficulty tolerating dose increases, use smaller increments or extend the interval between increases. The dose and extent of titration should be determined according to clinical response. The recommended dose for pediatric monotherapy is 3-6mg/kg daily. Doses up to 500㎎ daily have been used in children diagnosed with partial-onset seizures. Epilepsy adjunctive therapy, children (2 to 16 years): The recommended dose is approximately 5-9mg/kg daily, divided into 2 doses. During the first week, administer 25mg (or less, based on 1-3mg/kg daily) in the evening; thereafter, increase the daily dose by 1-3mg/kg at 1- to 2-week intervals and administer in 2 divided doses until an appropriate clinical effect is achieved. Dose titration should be determined according to clinical effect. Doses up to 30mg/kg daily have been administered and were generally well tolerated.

This medication may increase the risk of suicidal thoughts or behavior, so if any changes in mood or behavior occur during treatment, consult a doctor immediately. Patients with epilepsy taking this medication should be carefully monitored, as there is a possibility of sudden death. Severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which can cause serious skin reactions, may occur, so if such symptoms appear, discontinue the medication immediately and inform healthcare personnel. Do not use this medication if you have an allergy to any of its components or have certain genetic diseases like lactose intolerance. Women who may become pregnant or are planning to become pregnant should take a pregnancy test before taking this medication and should use effective contraception while taking it. This medication can be harmful to the fetus during pregnancy, so consulting a doctor is essential. Patients with impaired kidney or liver function should adjust dosages while carefully observing drug effects and side effects. This medication can cause central nervous system symptoms such as drowsiness, dizziness, and blurred vision, so caution should be taken when driving or operating dangerous machinery after taking it. Adequate hydration is important, and since there is a risk of kidney stones, it is advisable to drink plenty of water. Changes in weight or appetite may occur during medication, so if such symptoms arise, consult healthcare personnel. This medication may interact with other drugs, so it's crucial to inform your doctor or pharmacist if you are taking other medications. Suddenly stopping this medication may worsen seizures, so dosages should be gradually reduced following a doctor's instructions. This medication can reduce sweating and impact body temperature regulation; thus, caution is required, especially in hot weather. A condition called hyperammonemia may occur, which can lead to drowsiness or changes in consciousness; therefore, inform healthcare personnel immediately if such symptoms arise. It is essential to have regular medical check-ups while taking this medication to monitor for any abnormal symptoms.

• Suicidal ideation
• suicidal behavior
• depression
• abnormal changes in mood and behavior
• sudden death
• Stevens-Johnson syndrome
• toxic epidermal necrolysis
• perceptual disturbances
• stupor
• ataxia

This medication should be stored in a sealed container to prevent exposure to air and moisture. Additionally, it is important to store it in a cool and dry place below 25 degrees Celsius. Storing it this way will help maintain the medication's effectiveness for a longer period.

Appearance

Yellow round film-coated tablets

Package unit

30 tablets/bottle, 300 tablets/bottle