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Since many drugs are excreted in human milk, and because the potential for serious adverse reactions in nursing infants to topiramate is unknown, the potential benefit to the mother should be weighed against the potential risk to the infant when considering recommendations regarding nursing.

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Any sample testing positive resulted in the subject being sent home and rescheduled for another day (or released if UA was positive on more than one occassion).

When anxiety lingers regarding the risks or side effects of a medication (eg, NSAIDs or muscle relaxants), a short trial of the medication at a low dosage over 3-4 days can be effective for assessing the patient's tolerance and response to the drug, as well as alleviating patient and physician concerns.

Nevertheless, to the best of the inventor's knowledge, no one has made an observation of the efficacy of topiramate in the treatment of menopausal or perimenopausal vasomotor symptoms.

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ER in the treatment of overweight and obese patients have been evaluated in conjunction with lifestyle modification in three Phase III trials and one extension study.

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The effectiveness of topiramate as initial monotherapy in adults and children 10 years of age and older with partial onset or primary generalized seizures was established in a multicenter, randomized, double-blind, parallel-group trial.

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If metabolic acidosis develops and persists, consideration should be given to reducing the dose or discontinuing topiramate.

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Panic disorder, social phobia, specific phobias, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) significantly contribute to comorbidity.

The relative bioavailability of the drug from the tablet form is 80% compared with a solution.

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Topiramate may harm an unborn baby, but seizure during pregnancy can also be detrimental for both mother and baby.

However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Therapy with carbonic anhydrase inhibitors should be administered cautiously in patients with metabolic or hyperchloremic acidosis or with conditions that predispose to acidosis (renal disease, severe respiratory disorders, diarrhea).

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Potential interactions between Topiramate and standard AEDs were assessed in controlled clinical pharmacokinetic studies in patients with epilepsy.

The study reports that 43% of patients, who received topiramate at any dose, lost 1 to 6% of their initial body weight.

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McInryre RS: An open trial to document the safety and optimal dosing of topiramate as add-on therapy to mood stabilizers in the treatment of subjects with bipolar I or II disorder with unstable mood.

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This was an open-label (both the investigator and the patient knew the identity of the study drug), sequential treatment, multicenter study evaluating the interaction of topiramate and lithium in patients with bipolar disorders.

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These dose-related adverse reactions began with a similar frequency in the titration or in the maintenance phase, although in some patients the events began during titration and persisted into the maintenance phase.

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