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Topamax 25mg Film-Coated Tablets

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Document: leaflet MAH BRAND_PLPI 10383-1203 change

Topamax 25mg Film-Coated Tablets/ Topamax 50mg Film-Coated Tablets/ Topamax 100mg Film-Coated Tablets

(topiramate)

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

•    Keep this leaflet. You may need to read it again

•    If you have any further questions, ask your doctor or pharmacist

•    This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours

•    If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.


This product is available using any of the above names, but will be referred to as Topamax throughout this leaflet.

Topamax is also available as a 200mg strength.

Patient Information Leaflet

What is in this leaflet

1)    What Topamax is and what it is used for

2)    What you need to know before you take Topamax

3)    How to take Topamax

4)    Possible side effects

5)    How to store Topamax

6)    Contents of the pack and other information

1)    What Topamax is and what it is used for

Topamax belongs to a group of medicines called “antiepileptic medicines.” It is used:

•    alone to treat seizures in adults and children over age 6

•    with other medicines to treat seizures in adults and children aged 2 years and above

•    to prevent migraine headaches in adults

2)    What you need to know before you take Topamax Do not take Topamax

•    if you are allergic to topiramate or any of the other ingredients of this medicine (listed in section 6)

•    for migraine prevention if you are pregnant, or you are able to become pregnant but you are not using effective contraception (see section ‘pregnancy and breast-feeding' for further information)

If you are not sure if the above applies to you, talk to your doctor or pharmacist before using Topamax.

Warnings and precautions

Talk to your doctor or pharmacist before taking Topamax if you:

•    have kidney problems, especially kidney stones, or are getting kidney dialysis

•    have a history of blood and body fluid abnormality (metabolic acidosis)

•    have liver problems

•    have eye problems, especially glaucoma

•    have a growth problem

•    are on a high fat diet (ketogenic diet)

•    are pregnant or could become pregnant (see section ‘pregnancy and breast-feeding' for further information)

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Topamax.

It is important that you do not stop taking your medicine without first consulting your doctor.

You should also talk to your doctor before taking any medicine containing topiramate that is given to you as an alternative to Topamax.

You may lose weight if you use Topamax so your weight should be checked regularly when using this medicine. If you are losing too much weight or a child using this medicine is not gaining enough weight, you should consult your doctor.

A small number of people being treated with antiepileptic medicines such as Topamax have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor.

Other medicines and Topamax

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. Topamax and certain other medicines can affect each other. Sometimes the dose of some of your other medicines or Topamax will have to be adjusted.

Especially, tell your doctor or pharmacist if you are taking:

•    other medicines that impair or decrease your thinking, concentration, or muscle coordination (e.g., central nervous system depressant medicines such as muscle relaxants and sedatives)

•    birth control pills. Topamax may make your birth control pills less effective

Tell your doctor if your menstrual bleeding changes while you are taking birth control pills and Topamax.

Keep a list of all the medicines you take. Show this list to your doctor and pharmacist before you start a new medicine.

Other medicines you should discuss with your doctor or pharmacist include other antiepileptic medicines, risperidone, lithium, hydrochlorothiazide, metformin, pioglitazone, glyburide, amitriptyline, propranolol, diltiazem, venlafaxine, flunarazine, St. John's wort (Hypericum perforatum) (a herbal preparation used to treat depression).

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Topamax.

Topamax with food and drink

You can take Topamax with or without food. Drink plenty of fluids during the day to prevent kidney stones while taking Topamax. You should avoid drinking alcohol when taking Topamax.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

Your doctor will discuss use of contraceptives with you, as well as discussing whether Topamax is suitable for you. As with other anti-epileptic medicines, there is a risk of harm to the unborn child if Topamax is used during pregnancy. Make sure you are very clear about the risks and the benefits of using Topamax for epilepsy during pregnancy.

You should not take Topamax for migraine prevention if you are pregnant or you are able to become pregnant and you are not using effective contraception.

Mothers who breast-feed while taking Topamax must tell the doctor as soon as possible if the baby experiences anything unusual.

Driving and using machines

Dizziness, tiredness and vision problems may occur during treatment with Topamax. Do not drive or use any tools or machines without talking to your doctor first.

Topamax contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3)    How to take Topamax

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

•    Your doctor will usually start you on a low dose of Topamax and slowly increase your dose until the best dose is found for you

•    Topamax tablets are to be swallowed whole. Avoid chewing the tablets as they may leave a bitter taste

•    Topamax can be taken before, during, or after a meal. Drink plenty of fluids during the day to prevent kidney stones while taking Topamax

If you take more Topamax than you should

•    See a doctor right away. Take the medicine pack with you

•    You may feel sleepy, tired, or less alert; lack coordination; have difficulty speaking or concentrating, have double or blurred vision; feel dizzy due to low blood pressure; feel depressed or agitated; or have abdominal pain, or seizures (fits)

Overdose can happen if you are taking other medicines together with Topamax.

If you forget to take Topamax

•    If you forget to take a dose, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue as usual. If you miss two or more doses, contact your doctor

•    Do not take a double dose (two doses at the same time) to make up for a forgotten dose

If you stop taking Topamax

Do not stop taking this medicine unless told to do so by your doctor. Your symptoms may return. If your doctor decides to stop this medication, your dose may be decreased gradually over a few days.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4)    Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Tell your doctor, or seek medical attention immediately if you have the following side effects:

Very common (may affect more than 1 in 10 people)

•    Depression (new or worse)

Common (may affect up to 1 in 10 people)

•    Seizures (fits)

•    Anxiety, irritability, changes in mood, confusion, disorientation

•    Problems with concentration, slowness of thinking, loss of memory, problems with memory (new onset, sudden change or increased severity)

•    Kidney stone, frequent or painful urination

Uncommon (may affect up to 1 in 100 people)

•    Increased acid level in the blood (may cause troubled breathing including shortness of breath, loss of appetite, nausea, vomiting, excessive tiredness, and fast or uneven heart beats)

•    Decreased or loss of sweating (particularly in young children who are exposed to high temperatures)

•    Having thoughts of serious self-harm, trying to cause serious self-harm

•    Loss of part of the field of vision

Rare (may affect up to 1 in 1,000 people)

•    Glaucoma - blockage of fluid in eye causing increased pressure in the eye, pain, or decreased vision

Other side effects include the following, if they get serious, please tell your doctor or pharmacist:

Very common (may affect more than 1 in 10 people)

•    Stuffy, runny nose or sore throat

•    Tingling, pain and/or numbness of various body parts

•    Sleepiness, tiredness

•    Dizziness

•    Nausea, diarrhoea

•    Weight loss

Common (may affect up to 1 in 10 people)

•    Anaemia (low blood count)

•    Allergic reaction (such as skin rash, redness, itching, facial swelling, hives)

•    Loss of appetite, decreased appetite

•    Aggression, agitation, anger, abnormal behaviour

•    Difficulty falling or staying asleep

•    Problems with speech or speech disorder, slurred speech

•    Clumsiness or lack of coordination, feeling of unsteadiness when walking

•    Decreased ability to complete routine tasks

•    Decreased, loss of, or no sense of taste

•    Involuntary trembling or shaking; rapid, uncontrollable movements of the eyes

•    Visual disturbance, such as double vision, blurred vision, decreased vision, difficulty focusing

•    Sensation of spinning (vertigo), ringing in the ears, ear pain

•    Shortness of breath

•    Cough

•    Nose bleeds

•    Fever, not feeling well, weakness

•    Vomiting, constipation, abdominal pain or discomfort, indigestion, stomach or intestinal infection

•    Dry mouth

•    Hair loss

•    Itching

•    Joint pain or swelling, muscle spasms or twitching, muscle aches or weakness, chest pain

•    Weight gain

Uncommon (may affect up to 1 in 100 people)

•    Decrease in platelets (blood cells that help stop bleeding), decrease in white blood cells that help to protect you against infection, decrease in potassium level in the blood

•    Increase in liver enzymes, increase in eosinophils (a type of white blood cell) in the blood

•    Swollen glands in the neck, armpit, or groin

•    Increased appetite

•    Elevated mood

•    Hearing, seeing, or feeling things that are not there, severe mental disorder (psychosis)

•    Showing and/or feeling no emotion, unusual suspiciousness, panic attack

•    Problems with reading, speech disorder, problems with handwriting

•    Restlessness, hyperactivity

•    Slowed thinking, decreased wakefulness or alertness

•    Reduced or slow body movements, involuntary abnormal or repetitive muscle movements

•    Fainting

•    Abnormal sense of touch; impaired sense of touch

•    Impaired, distorted, or no sense of smell

•    Unusual feeling or sensation that may precede a migraine or a certain type of seizure

•    Dry eye, sensitivity of the eyes to light, eyelid twitching, watery eyes

•    Decreased or loss of hearing, loss of hearing in one ear

•    Slow or irregular heartbeat, feeling your heart beating in your chest

•    Low blood pressure, low blood pressure upon standing (consequently, some people taking Topamax may feel faint, dizzy, or may pass out when they stand up or sit up suddenly)

•    Flushing, feeling warm

•    Pancreatitis (inflammation of the pancreas)

•    Excessive passing of gas or wind, heartburn, abdominal fullness or bloating

•    Bleeding gums, increased saliva, drooling, breath odour

•    Excessive intake of fluids, thirst

•    Skin discolouration

•    Muscle stiffness, pain in side

•    Blood in urine, incontinence (lack of control) of urine, urgent desire to urinate, flank or kidney pain

•    Difficulty getting or keeping an erection, sexual dysfunction

•    Flu-like symptoms

•    Cold fingers and toes

•    Feeling drunk

•    Learning disability

Rare (may affect up to 1 in 1,000 people)

•    Abnormally elevated mood

•    Loss of consciousness

•    Blindness in one eye, temporary blindness, night blindness

•    Lazy eye

•    Swelling in and around the eyes

•    Numbness, tingling and colour change (white, blue then red) in fingers and toes when exposed to the cold

•    Inflammation of the liver, liver failure

•    Stevens Johnson syndrome, a potentially life-threatening condition that may present with sores in multiple mucosal sites (such as the mouth, nose, and eyes), a skin rash, and blistering

•    Abnormal skin odour

•    Discomfort in your arms or legs

•    Kidney disorder

Not known (frequency cannot be estimated from the available data)

•    Maculopathy is a disease of the macula, the small spot in the retina where vision is keenest. You should call your doctor if you notice a change or decrease in your vision.

•    Toxic epidermal necrosis, a life-threatening condition related to, yet more severe than, Stevens-Johnson syndrome, characterized by widespread blistering and sloughing of the outer layers of the skin (see rare side effects)

Children

The side effects in children are generally similar to those seen in adults, but the following side effects may be more common in children than adults:

•    Problems with concentration

•    Increased acid level in the blood

•    Having thoughts of serious self-harm

•    Tiredness

•    Decreased or increased appetite

•    Aggression, abnormal behaviour

•    Difficulty falling or staying asleep

•    Feeling of unsteadiness when walking

•    Not feeling well

•    Decrease in potassium level in the blood

•    Showing and/or feeling no emotion

•    Watery eyes

•    Slow or irregular heartbeat

Other side effects that may occur in children are:

Common (may affect up to 1 in 10 people)

•    Sensation of spinning (vertigo)

•    Vomiting

•    Fever

Uncommon (may affect up to 1 in 100 people)

•    Increase in eosinophils (a type of white blood cell) in the blood

•    Hyperactivity

•    Feeling warm

•    Learning disability

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5)    How to store Topamax

•    Keep out of the sight and reach of children.

•    Do not store above 25°C. Store in a dry place.

•    Do not use Topamax after the expiry date which is stated on the label. The expiry date refers to the last day of that month.

•    Medicines should not be disposed of via wastewater or household waste. These measures will help protect the environment. Return any leftover Topamax tablets to your pharmacist.

•    If the tablets become discoloured or show any other signs of deterioration, you should seek the advice of your pharmacist who will tell you what to do.

6)    Contents of the pack and other information

The active substance is topiramate.

25mg - Each tablet contains 25 mg of topiramate.

50mg - Each tablet contains 50 mg of topiramate.

100mg - Each tablet contains 100 mg of topiramate.

Each tablet also contains lactose monohydrate, pregelatinized maize starch, microcrystalline cellulose, sodium starch glycollate, magnesium stearate, canauba wax, hypromellose, titanium dioxide (E171), macrogol, and polysorbate 80. The 50mg and 100mg tablets also contain iron oxide (E172).

What Topamax looks like and contents of the pack

•    Topamax 25mg Tablets are round, white film-coated tablets marked ‘TOP' on one side and ‘25' on the reverse.

•    Topamax 50mg Tablets are round, light-yellow film-coated tablets marked ‘TOP' on one side and ‘50' on the reverse.

•    Topamax 100mg Tablets are round, yellow film-coated tablets marked ‘TOP' on one side and ‘100' on the reverse.

Topamax tablets are available as blister packs of 60 tablets.

PL 10383/1203 Topamax 25mg Film-Coated tablets    |POM|

PL 10383/1204 Topamax 50mg Film-Coated tablets PL 10383/1205 Topamax 100mg Film-Coated tablets

Who makes and repackages your medicine?

Your medicine is manufactured by Janssen Pharmaceutica N.V., Turnhoutseweg 30, 2340 Beerse, Belgium. Procured from within the EU and repackaged by Product Licence Holder Primecrown Ltd, 4/5 Northolt Trading Estate, Belvue Road, Northolt, Middlesex, UB5 5QS.

Leaflet date: 18.03.2016