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Safety Advices
বাংলা
English
UNSAFE
It is unsafe to consume alcohol with Piramed.
CONSULT YOUR DOCTOR
Piramed is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
CONSULT YOUR DOCTOR
Piramed is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
UNSAFE
Piramed may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
CAUTION
Piramed should be used with caution in patients with kidney disease. Dose adjustment of Piramed may be needed. Please consult your doctor.
CAUTION
Piramed should be used with caution in patients with liver disease. Dose adjustment of Piramed may be needed. Please consult your doctor.
Medicine Overview of Piramed 200mg Tablet
Introduction
Piramed is a medicine used to treat epilepsy (seizures) and to prevent migraines. It is also used in the treatment of Lennox-Gastaut syndrome (a rare, but severe form of epilepsy that starts in early childhood). Piramed controls seizures by decreasing the abnormal and excessive activity of the nerve cells in the brain. It may be taken with or without food, preferably at the same time, each day. If you have missed a dose, take it as soon as you remember it and finish the full course of treatment even if you feel better. Stopping the medication suddenly without talking to...
... Show moreUses of Piramed
- Epilepsy/Seizures
- Prevention of migraine
- Lennox–Gastaut syndrome
Side effects of Piramed
Common
- Abdominal pain
- Diarrhea
- Dizziness
- Fatigue
- Fever
- Loss of appetite
- Memory impairment
- Nausea
- Nervousness
- Numbness
- Psychomotor impairment
- Sleepiness
- Speech disorder
- Taste change
- Upper respiratory tract infection
- Visual impairment
- Weight loss
How to use Piramed
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Piramed may be taken with or without food, but it is better to take it at a fixed time.
How Piramed works
Piramed is an antiepileptic medication. It controls seizures or fits by decreasing the abnormal and excessive activity of the nerve cells in the brain.
What if you forget to take Piramed?
If you miss a dose of Piramed, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- Take your medication regularly as directed by your doctor as missing doses can trigger seizures.
- Do not change the brand of your medicine and make sure that you have sufficient amount of medicine present with you.
- Some healthy tips to prevent seizures:
- It may cause dizziness and sleepiness. Do not drive or do anything that requires mental focus until you know how it affects you.
- Keep yourself hydrated by drinking plenty of fluids throughout the day while taking Piramed. This can reduce the risk of kidney stones.
- Monitor your weight during treatment with this medicine as it can cause weight gain.
- Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
- Do not stop taking the medication suddenly without talking to your doctor as it may increase the seizure frequency.
Brief Description
Indication
Epilepsy, Migraine prophylaxis, Seizures associated w/ Lennox-gastaut syndrome
Administration
May be taken with or without food.
Adult Dose
Oral Partial-Onset or Primary Generalized Tonic-Clonic Seizures Monotherapy Adult: 25 mg PO q12hr initially; may increase by 50 mg/day at weekly intervals to 200 mg PO q12hr. Adjunctive therapy 25-50 mg/day PO initially; increase by 25-50 mg/day at weekly intervals to 100-200 mg q12hr for partial onset seizures and 200 mg q12hr. Lennox-Gastaut Syndrome Indicated as adjunctive therapy for seizures associated with Lennox-Gastaut syndrome (LGS) 25-50 mg/day PO initially; increase by 25-50 mg/day at weekly intervals to 100-200 mg q12hr Migraine Headache Indicated for prophylaxis of migraine headache Titrate over 4 wk to achieve a dose of 50 mg PO...
... Show moreChild Dose
Oral Partial-Onset or Primary Generalized Tonic-Clonic Seizures Monotherapy 38 kg: 250 mg/day minimum; 400 mg/day maximum >10 years 25 mg PO q12hr initially Titrate by increments of 50 mg/week up to 200 mg q12hr Adjunctive therapy 17 years: 25-50 mg/day PO initially; increase by 25-50 mg/day at weekly intervals to 100-200 mg q12hr for partial onset seizures and 200 mg q12hr for generalized tonic/clonic seizures Lennox-Gastaut Syndrome Adjunctive therapy 17 years: 25-50 mg/day PO initially; increase by 25-50 mg/day at weekly intervals to 100-200 mg q12hr for partial onset seizures and 200 mg q12hr for generalized tonic/clonic seizures Migraine Headache...
... Show moreRenal Dose
Renal impairment: Moderate to severe: Doses should be halved. Haemodialysis: supplemental dose equal to about ½ of the daily dose should be given in divided doses (at the start and finish of haemodialysis).
Contraindication
Contraindicated in persons showing hypersensitivity to any component of this preparation.
Mode of Action
Topiramate is a sulfamate-substituted monosaccharide with precise mechanism of action unknown. It may be due to various mechanisms e.g. blocking of voltage-dependent sodium channels; augmenting the activity of ?-aminobutyric acid (GABA) at GABA-A receptor; antagonising AMPA/kainate glutamate receptors; inhibiting carbonic anhydrase.
Precaution
Renal or hepatic impairment, pregnancy, lactation. May impair ability to drive or operate machinery. Maintain adequate hydration to reduce the risk of renal calculi especially in predisposed patients. Measure serum bicarbonate at baseline and periodically during treatment. Avoid abrupt withdrawal; decrease dose by 100 mg daily at wkly intervals. Seek immediate medical attention if blurred vision or eye pain. Monitor closely for decreased sweating and increased body temperature, especially in hot weather. Ensure proper hydration before and during activities or exposure to warm temperatures.
Lactation: Excreted in milk; use caution
Side Effect
>10%
Decrease in serum bicarbonate (7-67%),Dizziness (4-29%),Fatigue (9-16%),Ataxia (6-16%),Nervousness (9-18%),Paresthesia (1-11%),Psychomotor slowing (3-13%),Abnormal vision (2-13%),Anorexia (4-24%),Confusion (4-11%),Decreased memory (2-12%),Nausea (6-10%),Speech disorder (2-13%),Injury (14%)
1-10%
Abdominal pain (6-10%),Weight loss (4-9%),Diplopia (1-10%),Mood problems (<6%),Pharyngitis (6%),Tremor (3-9%),Abnormal gait (3-8%),Apathy (1%),Asthenia (1-5%),Dry mouth (2%),Menorrhagia (1-2%),Skin disorder (2-3%),Taste change (2%),Edema (2%),Hypertension (1-2%),Syncope (1%),Bradycardia (1%),Pallor (1%)
<1%
Angina,Erythema,Hepatic failure,Hyperthermia,Hypokalemia,Neuropathy,Toxic epidermal necrolysis
Interaction
Coadmin with antiepileptic drugs e.g. phenytoin, carbamazepine, phenobarbital decreases plasma concentration of topiramate. Possible increase in phenytoin levels. Increased risk of renal stone formation with carbonic anhydrase inhibitors e.g. acetazolamide. Increased risk of CNS depression with CNS depressants and alcohol. Increased risk of hyperammonaemia and encephalopathy with valproic acid. Increased risk of contraceptive failure in women taking combined oral contraceptives.
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