Select therapeutic use:

Migraine and headache:

Indications for: EPRONTIA

Migraine prophylaxis.

Adult Dosage:

Give in two equally divided doses. Titrate at 1-week intervals to target dose of 100mg/day. Initially 25mg once daily in the PM, then 25mg twice daily, then 25mg in the AM and 50mg in the PM, then 50mg twice daily. Renal impairment (CrCl <70mL/min): reduce dose by ½. Hemodialysis: may need extra dose.

Children Dosage:

Not established.

EPRONTIA Warnings/Precautions:

Discontinue if acute myopia, secondary angle-closure glaucoma occur. Consider discontinuing if visual field defects occur. Kidney stones. Maintain adequate hydration and caloric intake; avoid ketogenic diets. Measure serum bicarbonate at baseline, then periodically during therapy; consider reducing dose or discontinuing if metabolic acidosis develops and persists. Inborn errors of metabolism or reduced hepatic mitochondrial activity: increased risk of hyperammonemia; measure ammonia levels if encephalopathic symptoms occur. Monitor on growth (during prolonged therapy), oligohidrosis, and hyperthermia esp. in children. Suicidal tendencies (monitor). Discontinue at the 1st sign of a rash. Avoid abrupt cessation. Hepatic or renal impairment. Elderly. Fetal toxicity (eg, congenital malformations, oral clefts, small for gestational age). Labor & delivery. Pregnancy. Advise females of reproductive potential to use effective contraception during therapy. Nursing mothers.

EPRONTIA Classification:

Sulfamate.

EPRONTIA Interactions:

Concomitant other carbonic anhydrase inhibitors (eg, zonisamide, acetazolamide); monitor closely for acidosis. Antagonized by phenytoin, carbamazepine, valproic acid, lamotrigine; dose adjustment may be needed. Antagonizes valproic acid levels, glyburide, and diltiazem. May antagonize digoxin, oral contraceptives, risperidone, pioglitazone (monitor glucose control). May potentiate phenytoin levels, amitriptyline, metformin. May be potentiated by hydrochlorothiazide. Potentiated by diltiazem. CNS depression potentiated with alcohol, other CNS depressants. Hyperammonemia (w/ or w/o encephalopathy) and/or hypothermia possible with valproic acid. Caution with other drugs that interfere with temperature regulation (eg, anticholinergics, carbonic anhydrase inhibitors). Monitor lithium levels with high-dose topiramate.

Adverse Reactions:

Paresthesia, anorexia, weight decrease, taste perversion, upper RTI, abdominal pain, diarrhea, hypoesthesia, nausea, dizziness, nervousness, fatigue, somnolence, cognitive-related dysfunction (eg, confusion, psychomotor slowing, difficulty with memory, difficulty with concentration/attention, speech or language problems), psychiatric/behavioral disturbances (eg, depression, mood problems), fever, infection, flushing; serious skin reactions (eg, SJS, TEN), decrease in bone mineral density.

Generic Drug Availability:

NO

How Supplied:

Soln—473mL

Pricing for EPRONTIA

473ml of 25mg/ml bottle of oral solution (Qty: 1)
Appx. price $662
GoodRx

Seizure disorders:

Indications for: EPRONTIA

Initial monotherapy and adjunct in partial-onset or primary generalized tonic-clonic seizures. Adjunct in Lennox-Gastaut syndrome.

Adult Dosage:

Give in two equally divided doses. Monotherapy: initially 50mg/day, increase at 1-week intervals by increments of 50mg/week for the 1st 4 weeks, then increase by 100mg/week for Weeks 5–6 to target dose of 400mg/day. Adjunctive therapy: ≥17yrs: initially 25–50mg/day, increase at 1-week intervals by 25–50mg/day every week (see full labeling) to target dose of 200–400mg/day (partial onset seizures or Lennox-Gastaut syndrome) or 400mg/day (primary generalized tonic-clonic seizures). Renal impairment (CrCl <70mL/min): reduce dose by ½. Hemodialysis: may need extra dose.

Children Dosage:

Give in two equally divided doses. Monotherapy: <2yrs: not established. 2–<10yrs (dosing based on weight): initially 25mg/day in the PM for the 1st week, then increase to 50mg/day in the 2nd week; subsequently, may increase weekly by 25–50mg/day as tolerated. Titration to the minimum or max maintenance dose should be attempted over 5–7 weeks: see full labeling. ≥10yrs: initially 50mg/day, increase at 1-week intervals by increments of 50mg/week for the 1st 4 weeks, then increase by 100mg/week for Weeks 5–6 to target dose of 400mg/day. Adjunctive therapy: <2yrs: not established. 2–16yrs: initially 1–3mg/kg (max 25mg) per day given in the PM for 1 week, increase at 1–2 week intervals by 1–3mg/kg/day to target range of 5–9mg/kg/day in 2 divided doses. Max: 400mg/day. Renal impairment (CrCl <70mL/min): reduce dose by ½. Hemodialysis: may need extra dose.

EPRONTIA Warnings/Precautions:

Discontinue if acute myopia, secondary angle-closure glaucoma occur. Consider discontinuing if visual field defects occur. Kidney stones. Maintain adequate hydration and caloric intake; avoid ketogenic diets. Measure serum bicarbonate at baseline, then periodically during therapy; consider reducing dose or discontinuing if metabolic acidosis develops and persists. Inborn errors of metabolism or reduced hepatic mitochondrial activity: increased risk of hyperammonemia; measure ammonia levels if encephalopathic symptoms occur. Monitor on growth (during prolonged therapy), oligohidrosis, and hyperthermia esp. in children. Suicidal tendencies (monitor). Discontinue at the 1st sign of a rash. Avoid abrupt cessation. Hepatic or renal impairment. Elderly. Fetal toxicity (eg, congenital malformations, oral clefts, small for gestational age). Labor & delivery. Pregnancy. Advise females of reproductive potential to use effective contraception during therapy. Nursing mothers.

EPRONTIA Classification:

Sulfamate.

EPRONTIA Interactions:

Concomitant other carbonic anhydrase inhibitors (eg, zonisamide, acetazolamide); monitor closely for acidosis. Antagonized by phenytoin, carbamazepine, valproic acid, lamotrigine; dose adjustment may be needed. Antagonizes valproic acid levels, glyburide, and diltiazem. May antagonize digoxin, oral contraceptives, risperidone, pioglitazone (monitor glucose control). May potentiate phenytoin levels, amitriptyline, metformin. May be potentiated by hydrochlorothiazide. Potentiated by diltiazem. CNS depression potentiated with alcohol, other CNS depressants. Hyperammonemia (w/ or w/o encephalopathy) and/or hypothermia possible with valproic acid. Caution with other drugs that interfere with temperature regulation (eg, anticholinergics, carbonic anhydrase inhibitors). Monitor lithium levels with high-dose topiramate.

Adverse Reactions:

Paresthesia, anorexia, weight decrease, dizziness, nervousness, abnormal vision, fever, fatigue, somnolence, cognitive-related dysfunction (eg, confusion, psychomotor slowing, difficulty with memory, difficulty with concentration/attention, speech or language problems), psychiatric/behavioral disturbances (eg, depression, mood problems), infection, flushing, taste perversion; sudden unexplained death in epilepsy, serious skin reactions (eg, SJS, TEN), decrease in bone mineral density.

Generic Drug Availability:

NO

How Supplied:

Soln—473mL

Pricing for EPRONTIA

473ml of 25mg/ml bottle of oral solution (Qty: 1)
Appx. price $662
GoodRx