Qudexy XR

1 What is Qudexy XR?

Brand: Qudexy XR, Topamax, Topiragen, Trokendi XR

Generic: Topiramate

Qudexy XR is a prescription-only anti-seizure drug that controls epileptic seizures such as partial seizures, tonic-clonic seizures, or Lennox-Gastaut syndrome.

Doctors can also prescribe topiramate for prevention of migraine headaches. It is available as:

  • Tablet
  • Capsule
  • Extended release capsule

2 What to Know Before Using

Before using Qudexy XR, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will provide you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

  • Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.
  • Pediatric: Not enough is known about the safety and efficacy of using topiramate for controlling seizures in children below 6 years, or for preventing migraine headaches in children below 12 years. Your doctor can make decisions about using this medicine in children of this age group.
  • Geriatric: It may be used cautiously in elderly after adjusting the dose.
  • Pregnancy: It falls under pregnancy category D for all trimesters meaning that topiramate carries some risks to the fetus but it may be used in a life threatening situation.
  • Breastfeeding: It may be used in a nursing mother after assessing the risks and benefits of using this medicine.
  • Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions. Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use topiramate with any of the following medicines:

        o Bromazepam
        o Buprenorphine
        o Citalopram Clozapine Fentanyl
        o Morphine
        o Nifedipine Orlistat
        o Sodium Oxybate
        o Suvorexant
        o Tapentadol

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects. In such cases, you may have to take the adjusted dose or change the frequency of intake.

        o Amitriptyline
        o Carbamazepine
        o Desogestrel
        o Estradiol Cypionate
        o Estradiol Valerate
        o Ethinyl Estradiol
        o Levonorgestrel
        o Medroxyprogesterone Acetate
        o Mestranol
        o Norelgestromin
        o Norethindrone
        o Phenytoin
        o Pioglitazone
        o Valproic Acid

  • Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. DO NOT drink while taking topiramate.
  • Medical Problems: Certain medical conditions might influence the effects (both positive and adverse) and action of topiramate. DO NOT forget to inform your doctor about the following conditions that might affect your drug’s effect, including:

        o Depression
        o Glaucoma
        o History of metabolic acidosis (increased blood acidity)
        o Osteoporosis (decreased bone mass): Use cautiously
        o Diarrhea
        o Breathing difficulties
        o Intake of ketogenic diet: Increases chances of metabolic acidosis
        o Kidney or Liver problems: (Use cautiously)
        o Patients taking metformin and also have metabolic acidosis: (Do not use topiramate).

3 Proper Usage

To use Qudexy XR properly, you must follow all instructions given by your doctor.

  • Follow your doctor’s instructions and do not take more, less, more frequently or for a longer duration than recommended.
  • Read the patient information leaflet and follow accordingly.
  • Do not break, or chew the extended-release capsule.
  • Do not drink alcohol while taking topiramate. If you need to, maintain a gap of at least six hours.
  • Increasing water intake can help prevent kidney stones.

Dosing:

For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed. Remember your doses can differ.

Consult your doctor if you have anything to ask.

1. Extended-release capsules

For seizures (in combination with other medicines)

  • Adults: Start with 25 or 50 milligrams (mg) once a day. Then the dose may be adjusted but do not take more than 400 mg per day.
  • Children 2 years and older: Start with 25 mg once a day in the evening. Then the dose may be adjusted but do not give more than 5 to 9 mg per kg body weight per day.
  • Children younger than 2 years of age: Not recommended.
  • Children 6 years of age and older: Start with a daily evening dose of 25 mg. Then the dose may be adjusted but do not give more than 5 to 9 mg per kg body weight per day.
  • Children younger than 6 years of age: Not recommended.

For seizures (used alone)

  • Adults, teenagers, and children 10 years and older: Start with 50 milligrams (mg) once a day. Then the dose may be adjusted but do not take more than 400 mg per day.
  • Children below 10 years: Your doctor will decide the use and dose.

2. Capsules or tablets

For seizures (in combination with other medicines)

  • Adults and children 17 years and older: Start with 25 or 50 milligrams (mg) once a day. Then the dose may be adjusted but do not take more than 400 mg per day.
  • Children 2 to 16: Start with a daily evening dose of 25 mg. Then the dose may be adjusted on the basis of body weight.
  • Children younger than 2 years: Your doctor will decide the use and dose.

For seizures (used alone)

  • Adults, teenagers, and children 10 years and older: Start with 50 milligrams (mg) per day, in 2 divided doses. Then the dose may be adjusted but do not take more than 400 mg per day.
  • Children 2 to less than 10 years: Start with 25 mg once a day in the evening. Then the dose may be adjusted on the basis of body weight but do not give than 250 to 400 mg per day.
  • Children younger than 2 years: Your doctor will decide the use and dose.

For migraine headaches

  • Adults and children 12 years and older: Start with a daily evening dose of 25 milligrams (mg). Then the dose may be adjusted but do not give more than 100 mg per day.
  • Children younger than 12 years: Your doctor will decide the use and dose.

Missed Dose:

Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose. Do not miss more than a dose. If you do, call your doctor before restarting it.

Storage

  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.

4 Precautions to Take

Before using Qudexy XR, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment or have undesirable side effects. Remember:

  • Topiramate can harm your baby in the womb. Do not get pregnant if you are using this medicine. Immediately call your doctor if you suspect of becoming pregnant.
  • Topiramate may interfere with some estrogen-containing contraceptive pills.
  • As topiramate can cause slowed response, vision problems or dizziness, take special care doing activities that require alertness and good vision, such as, driving or using machines.
  • Using topiramate with alcohol and other CNS depressants such as allergy medications, sleeping pills or cold medications can increase dizziness or sleepiness.
  • Call your doctor immediately if you experience eye pain or vision problems while taking topiramate or even after finishing the course.
  • Inform your doctor immediately if you feel depressed, irritated, or suicidal.
  • Inform your doctor immediately if you have rapid heartbeats, breathing difficulties or agitation.
  • Topiramate can increase the acidity of your blood resulting in metabolic acidosis.
  • Do not discontinue any medicine on your own. For topiramate, the dose is gradually tapered and then discontinued.
  • Topiramate may cause a serious condition called hyperammonemia encephalopathy the symptoms of which include:

        o Excessive drowsiness, tiredness, weakness.
        o Slowed response
        o Depression or anxiety
        o Nightmares

Visit your doctor immediately if you develop any of the symptoms above.

  • Topiramate can also cause kidney stones. Therefore, look out for the symptoms like:

        o Sudden back pain
        o Abdominal pain
        o Painful urination
        o Blood in urine

  • You may also have numbness, tingling or crawling sensations in the skin. Inform your doctor about this.
  • Consult your doctor about using other prescription or nonprescription medicines and herbal or vitamin supplements while taking topiramate.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Qudexy XR.

Check with your doctor immediately if any of the following side effects occur:

More common:

  • Blurry vision, double vision, eye pain, rapid vision loss or abnormal eye movements
  • Burning, prickling, or tingling sensations
  • Confusion
  • Dizziness and drowsiness
  • Slow to respond
  • Memory problems
  • Abnormal menstruation
  • Speech or language problems
  • Excessive tiredness

Less common:

  • Abdominal pain
  • Fever, chills, or a sore throat
  • Decreased sensations or perception
  • Reduced hunger
  • Mood problems such as aggression, depression, and restlessness
  • Gum bleeding

Rare:

  • Appearance of blood in urine
  • Reduced sex drive or performance
  • Pain or during urination
  • Hearing impairment
  • Loss of control over bladder
  • Pain in lower back or side
  • Bleeding from nose
  • Pale skin
  • Eye irritation or reddening
  • Abnormal hearing
  • Rash or itchy skin
  • Breathing difficult

Seek emergency medical attention if you experience any of the symptoms of overdose, including:

  • Slowed response
  • Reduced awareness
  • Dizziness
  • Fainting
  • Excessive drowsiness or weakness

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

More common:

  • Tender breast in females
  • Shaking

Less common:

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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