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The physicochemical identification and / or indicia may be coupled to at least one section of the … Tranylcypromine (sold under the trade name Parnate among others) is a monoamine oxidase inhibitor (MAOI); more specifically, tranylcypromine acts as nonselective and irreversible inhibitor of the enzyme monoamine oxidase (MAO). Homeschool Days; School & Youth Programs. lamictal-lamotrigine-343012


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Contact the applicable plan Indicated as adjunctive therapy for seizures associated with Lennox-Gastaut syndrome (LGS)Topamax, Topamax Sprinkles: 25-50 mg/day PO initially; increase by 25-50 mg/day at weekly intervals to 100-200 mg q12hrTrokendi XR, Qudexy XR: 25-50 mg PO qDay initially; increase by 25-50 mg/day at weekly intervals to achieve effective dose; not to exceed 200-400 mg/dayGuide dose/titration rate by clinical outcome; if needed, use longer intervals between dose adjustmentsIncrease by 25 mg/day every week to no more than 200 mg/dayMay increase to maximum 300 mg/day by weeks 5-14; may divide 300 mg dose q8hr (case reports)Maintenance: 200 mg/day divided q12hr or 300 mg/day divided q8hrOrphan designation for Captisol-enabled topiramate injection for the treatment of partial onset or primary generalized tonic-clonic seizures in hospitalized patients with epilepsy or those being treated in an emergency care setting who are unable to take oral topiramateGuide dose/titration rate by clinical outcome; if needed, use longer intervals between dose adjustmentsIncreased risk for bleeding; in patients with serious bleeding events, conditions that increased the risk for bleeding were presentBody as a whole-general disorders: Oligohydrosis and hyperthermia, hyperammonemia, hyperammonemic encephalopathy, hypothermia with concomitant valproic acidGastrointestinal system disorders: Hepatic failure (including fatalities), hepatitis, pancreatitisUrinary system disorders: Kidney stones, nephrocalcinosisVision disorders: Acute myopia, secondary angle closure glaucoma, maculopathy, acute myopia, secondary angle closure glaucomaExtended release: Within 6 hr of alcohol intake; patients with metabolic acidosis that are taking metformin concomitantlyMaintain adequate fluid intake due to kidney stone riskMonitor closely for decreased sweating and increased body temperature; oligohydrosis reported with use; monitor during strenuous exerciseConcomitant use of drugs that predispose patients to heat-related disorders (such as carbonic anhydrase inhibitors and anticholinergics)Coadministration with valproic acid increases risk of hyperammonemia (with or without encephalopathy)Risk of hyperchloremic, non-anion gap, metabolic acidosis; especially if concomitant renal disease, severe respiratory disorder, status epilepticus, diarrhea, surgery, ketogenic diet, or drugs predisposing to acidosis; if metabolic acidosis develops and persists, consideration should be given to reducing dose or discontinuing therapy (using dose tapering); if decision is made to continue patients on therapy in face of persistent acidosis, alkali treatment should be consideredRisks of acute myopia and secondary angle-closure glaucoma (discontinue immediately if vision problems)Visual field defects reported independent of elevated IOP; reversible upon discontinuationRapid titration rate, dose, and higher initial dose associated with higher incidence of neuropsychiatric disorder in both epilepsy and migraine patients; also associated with higher incidences of cognitive-related dysfunctionMonitor serum bicarbonate at baseline and then periodically; may also monitor serum chloride, ammonia, and phosphorusWhen discontinuing drug, gradually withdraw to decrease risk of seizure or increased seizure frequencyIncreased risk in suicidal thoughts/behavior reported; monitor patients for notable changes in behavior and notify healthcare provider if symptoms occurHypothermia reported with and without hyperammonemia during topiramate treatment with concomitant valproic acid use; consideration should be given to stopping topiramate or valproate in patients who develop hypothermiaHyperammonemia with or without encephalopathy with monotherapy or in combination with valproic acid reported in patients that have tolerated each drug alone; risk may increase in patients with inborn errors of metabolism or decreased hepatic mitochondrial activity; monitor for vomiting, lethargy, or unusual changes in mental status; in some patients, hyperammonemia can be asymptomaticInfants exposed to topiramate in utero may have an increased risk for cleft lip and/or cleft palate (oral clefts) and for being small for gestational ageWomen of childbearing potential who are not planning a pregnancy should use effective contraception because of risks to fetus of oral clefts and of being small for gestational ageThere is pregnancy exposure registry that monitors pregnancy outcomes in women exposed to drug during pregnancy; to enroll, patients can call the toll-free number 1-888-233-2334.


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