{"id":52180,"date":"2023-09-20T09:30:01","date_gmt":"2023-09-20T09:30:01","guid":{"rendered":"https:\/\/medsname.com\/topaz\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"topaz","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/topaz\/","title":{"rendered":"Topaz"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Topaz?<\/h3>\n<p style=\"margin:0;\"><strong>Topaz<\/strong> je peror\u00e1ln\u00ed <strong>topiram\u00e1t<\/strong> (25 mg, 50 mg) antikonvulzivum a l\u00e9k na profylaxi migr\u00e9ny. Pou\u017e\u00edv\u00e1 se p\u0159i: <strong>parci\u00e1ln\u00edch a prim\u00e1rn\u00edch generalizovan\u00fdch tonicko-klonick\u00fdch z\u00e1chvatech<\/strong>, <strong>Lennox-Gastautov\u011b syndromu<\/strong>, a <strong>profylaxe migr\u00e9ny<\/strong> u dosp\u011bl\u00fdch a dosp\u00edvaj\u00edc\u00edch. D\u00e1vkov\u00e1n\u00ed u dosp\u011bl\u00fdch: titrace od 25 mg\/den do <strong>100\u2013400 mg\/den<\/strong> ve 2 rozd\u011blen\u00fdch d\u00e1vk\u00e1ch (epilepsie) nebo 50\u2013100 mg\/den (migr\u00e9na). U\u017e\u00edvejte s j\u00eddlem nebo bez, pijte dostatek vody. N\u00e1stup \u00fa\u010dinku: 4\u20138 t\u00fddn\u016f pro pln\u00fd \u00fa\u010dinek u migr\u00e9ny. Charakteristick\u00fd profil ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f: <strong>\u00fabytek hmotnosti, parest\u00e9zie (brn\u011bn\u00ed), obt\u00ed\u017ee s vybavov\u00e1n\u00edm slov, ledvinov\u00e9 kameny, metabolick\u00e1 acid\u00f3za, uzav\u0159en\u00fd \u00fahel glaukomu<\/strong>. <strong>Siln\u011b teratogenn\u00ed \u2013 riziko roz\u0161t\u011bpu rtu\/patra<\/strong> \u2014 nepou\u017e\u00edvejte v t\u011bhotenstv\u00ed, pokud to nen\u00ed nezbytn\u011b nutn\u00e9. Nikdy nep\u0159est\u00e1vejte n\u00e1hle \u2013 riziko rebound z\u00e1chvat\u016f.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Topaz?<\/h2>\n<p>Topaz je peror\u00e1ln\u00ed tableta topiram\u00e1tu dostupn\u00e1 v sil\u00e1ch 25 mg a 50 mg. Topiram\u00e1t je sulfam\u00e1tem substituovan\u00fd monosacharidov\u00fd antikonvulzivum zaveden\u00fd v 90. letech 20. stolet\u00ed, s jedine\u010dn\u011b \u0161irok\u00fdm mechanismem \u00fa\u010dinku, kter\u00fd mu zaji\u0161\u0165uje \u00fa\u010dinnost p\u0159i <strong>fok\u00e1ln\u00edch a generalizovan\u00fdch z\u00e1chvatech<\/strong>, <strong>profylaxe migr\u00e9ny<\/strong>, a prok\u00e1zan\u00fd \u00fa\u010dinek na <strong>\u00fabytek hmotnosti<\/strong> (je sou\u010d\u00e1st\u00ed schv\u00e1len\u00e9ho l\u00e9ku na obezitu Qsymia\u00ae spolu s fenterminem).<\/p>\n<p>Topaz je dod\u00e1v\u00e1n v\u00fdrobcem certifikovan\u00fdm WHO-GMP a je bioekvivalentn\u00ed k origin\u00e1ln\u00ed zna\u010dce Topamax\u00ae (Janssen) ve stejn\u00e9 miligramov\u00e9 s\u00edle.<\/p>\n<h2 class=\"wp-block-heading\">Jak Topaz funguje?<\/h2>\n<p>Topiram\u00e1t m\u00e1 nejm\u00e9n\u011b p\u011bt dopl\u0148uj\u00edc\u00edch se mechanism\u016f:<\/p>\n<ul>\n<li><strong>Blok\u00e1da nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch sod\u00edkov\u00fdch kan\u00e1l\u016f<\/strong> \u2013 sni\u017euje vysokofrekven\u010dn\u00ed neuron\u00e1ln\u00ed v\u00fdboje v lo\u017eisc\u00edch z\u00e1chvat\u016f.<\/li>\n<li><strong>Zv\u00fd\u0161en\u00e1 aktivita GABA-A receptor\u016f<\/strong> na nebenzodiazepinov\u00e9m m\u00edst\u011b \u2013 zvy\u0161uje inhibi\u010dn\u00ed neurotransmisi.<\/li>\n<li><strong>Antagonismus AMPA\/kain\u00e1tov\u00fdch glutam\u00e1tov\u00fdch receptor\u016f<\/strong> \u2013 sni\u017euje excita\u010dn\u00ed neurotransmisi.<\/li>\n<li><strong>Inhibice nap\u011b\u0165ov\u011b aktivovan\u00fdch kalciov\u00fdch kan\u00e1l\u016f typu L<\/strong>.<\/li>\n<li><strong>Inhibice karboanhydr\u00e1zy<\/strong> (izoformy II a IV) \u2014 z\u00e1klad vedlej\u0161\u00edch \u00fa\u010dink\u016f (parestezie, ledvinov\u00e9 kameny, metabolick\u00e1 acid\u00f3za) a pravd\u011bpodobn\u011b \u010d\u00e1st \u00fa\u010dink\u016f na migr\u00e9nu a hubnut\u00ed.<\/li>\n<\/ul>\n<p>Tato polyfarmakologie d\u00e1v\u00e1 topiram\u00e1tu \u0161irokou \u00fa\u010dinnost, ale tak\u00e9 jeho charakteristick\u00fd profil vedlej\u0161\u00edch \u00fa\u010dink\u016f \u2014 \u00fa\u010dinky souvisej\u00edc\u00ed s karbonickou anhydr\u00e1zou (parestezie, ledvinov\u00e9 kameny, metabolick\u00e1 acid\u00f3za, glaukom) jsou mezi modern\u00edmi antikonvulzivy unik\u00e1tn\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<ul>\n<li><strong>Parci\u00e1ln\u00ed (fok\u00e1ln\u00ed) z\u00e1chvaty<\/strong> \u2014 monoterapie a adjuvantn\u00ed l\u00e9\u010dba (schv\u00e1leno FDA)<\/li>\n<li><strong>Prim\u00e1rn\u00ed generalizovan\u00e9 tonicko-klonick\u00e9 z\u00e1chvaty<\/strong> \u2014 monoterapie a adjuvantn\u00ed l\u00e9\u010dba<\/li>\n<li><strong>Lennox-Gastautov\u011b syndromu<\/strong> \u2014 adjuvantn\u00ed l\u00e9\u010dba<\/li>\n<li><strong>Profylaxe migr\u00e9ny<\/strong> u dosp\u011bl\u00fdch a adolescent\u016f 12+ \u2014 schv\u00e1leno FDA (nej\u010dast\u011bj\u0161\u00ed d\u016fvod u\u017eit\u00ed u neepileptick\u00fdch pacient\u016f)<\/li>\n<li><strong>Mimo indikaci:<\/strong> obezita (sou\u010d\u00e1st p\u0159\u00edpravku Qsymia\u00ae), porucha p\u0159\u00edjmu potravy s z\u00e1chvatovit\u00fdm p\u0159ej\u00edd\u00e1n\u00edm, porucha u\u017e\u00edv\u00e1n\u00ed alkoholu (skromn\u00e9 d\u016fkazy), idiopatick\u00e1 intrakrani\u00e1ln\u00ed hypertenze, esenci\u00e1ln\u00ed tremor (skromn\u00e9)<\/li>\n<\/ul>\n<p>Topaz je <strong>ne<\/strong> prvn\u00ed volba u: absence (pou\u017eijte ethosuximid nebo valpro\u00e1t), akutn\u00ed m\u00e1nie (pou\u017eijte valpro\u00e1t nebo atypick\u00e9 antipsychotikum), \u010dist\u00e9 \u00fazkostn\u00e9 poruchy.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed p\u0159\u00edpravku Topaz a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<p>Dostupn\u00e9 s\u00edly p\u0159\u00edpravku Topaz: <strong>25 mg, 50 mg<\/strong>.<\/p>\n<p><strong>Standardn\u00ed d\u00e1vkov\u00e1n\u00ed pro dosp\u011bl\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Profylaxe migr\u00e9ny:<\/strong> T\u00fdden 1 \u2014 25 mg p\u0159ed span\u00edm. T\u00fdden 2 \u2014 25 mg dvakr\u00e1t denn\u011b. T\u00fdden 3 \u2014 25 mg r\u00e1no + 50 mg ve\u010der. T\u00fdden 4 \u2014 50 mg dvakr\u00e1t denn\u011b (c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed 100 mg\/den). N\u011bkte\u0159\u00ed pacienti reaguj\u00ed na 50 mg\/den; n\u011bkte\u0159\u00ed pot\u0159ebuj\u00ed 200 mg\/den.<\/li>\n<li><strong>Epilepsie (p\u0159\u00eddatn\u00e1 l\u00e9\u010dba):<\/strong> Za\u010dn\u011bte s 25\u201350 mg\/den; zvy\u0161ujte o 25\u201350 mg ka\u017ed\u00fdch 1\u20132 t\u00fddny. Udr\u017eovac\u00ed d\u00e1vka 200\u2013400 mg\/den ve 2 d\u00e1vk\u00e1ch. U monoterapie je udr\u017eovac\u00ed d\u00e1vka podobn\u00e1.<\/li>\n<li><strong>D\u011bti &gt;2 roky (p\u0159\u00eddatn\u00e1 l\u00e9\u010dba epilepsie):<\/strong> 5\u20139 mg\/kg\/den ve 2 d\u00e1vk\u00e1ch, pomalu titrov\u00e1no.<\/li>\n<li><strong>Porucha funkce ledvin<\/strong> (ClCr &lt;70 ml\/min): polovi\u010dn\u00ed d\u00e1vka; dial\u00fdza: po dial\u00fdze je nutn\u00e1 dopl\u0148kov\u00e1 d\u00e1vka.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Jak spr\u00e1vn\u011b u\u017e\u00edvat p\u0159\u00edpravek Topaz<\/h3>\n<ol>\n<li><strong>Pomal\u00e1 titrace je z\u00e1sadn\u00ed.<\/strong> Rychlej\u0161\u00ed navy\u0161ov\u00e1n\u00ed nedos\u00e1hne rychlej\u0161\u00edho \u00fa\u010dinku, ale spolehliv\u011b zp\u016fsob\u00ed v\u00edce kognitivn\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f, parestezi\u00ed a vysazen\u00ed l\u00e9\u010dby. V\u011bt\u0161ina p\u0159eru\u0161en\u00ed l\u00e9\u010dby je zp\u016fsobena vedlej\u0161\u00edmi \u00fa\u010dinky, kter\u00e9 jsou z velk\u00e9 \u010d\u00e1sti spojeny s titrac\u00ed.<\/li>\n<li><strong>S j\u00eddlem nebo bez j\u00eddla.<\/strong> Pijte dostatek vody (2\u20133 l\/den), abyste sn\u00ed\u017eili riziko vzniku ledvinov\u00fdch kamen\u016f \u2014 zejm\u00e9na pokud \u017eijete v hork\u00e9m podneb\u00ed, provozujte nam\u00e1hav\u00e9 cvi\u010den\u00ed nebo dr\u017e\u00edte ketogenn\u00ed\/n\u00edzkosacharidovou dietu.<\/li>\n<li><strong>Dvakr\u00e1t denn\u011b<\/strong> v udr\u017eovac\u00ed f\u00e1zi. Jednou denn\u011b 25\u201350 mg p\u0159ed span\u00edm je rozumn\u00e9 v po\u010d\u00e1te\u010dn\u00edch t\u00fddnech titrace.<\/li>\n<li><strong>Udr\u017eujte terapeutickou d\u00e1vku po dobu 4\u20138 t\u00fddn\u016f<\/strong> p\u0159ed hodnocen\u00edm \u00fa\u010dinku na migr\u00e9ny. Profylaxe migr\u00e9ny nen\u00ed v\u0161e nebo nic \u2014 realistick\u00fdm c\u00edlem je 50% sn\u00ed\u017een\u00ed po\u010dtu migren\u00f3zn\u00edch dn\u016f za m\u011bs\u00edc.<\/li>\n<li><strong>Vyhn\u011bte se ketogenn\u00ed diet\u011b a Atkinsov\u011b diet\u011b<\/strong> \u2014 v kombinaci s inhibic\u00ed karboanhydr\u00e1zy topiram\u00e1tem tyto diety v\u00fdrazn\u011b zvy\u0161uj\u00ed riziko metabolick\u00e9 acid\u00f3zy a ledvinov\u00fdch kamen\u016f.<\/li>\n<li><strong>Informujte ka\u017ed\u00e9ho p\u0159edepisuj\u00edc\u00edho l\u00e9ka\u0159e.<\/strong> Topiram\u00e1t interaguje s kombinovan\u00fdmi peror\u00e1ln\u00edmi antikoncepcemi (sni\u017euje hladinu estrogenu nad 200 mg\/den), dal\u0161\u00edmi antikonvulzivy a lithiem.<\/li>\n<li><strong>Nikdy nep\u0159est\u00e1vejte n\u00e1hle.<\/strong> N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat <strong>rebound z\u00e1chvaty<\/strong> u pacient\u016f s epilepsi\u00ed (i u t\u011bch, kte\u0159\u00ed byli roky bez z\u00e1chvat\u016f) a rebound migr\u00e9nu. Sni\u017eujte d\u00e1vku postupn\u011b po dobu 2\u20134 t\u00fddn\u016f pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/li>\n<li><strong>Zm\u011bny vid\u011bn\u00ed \u2014 nouzov\u00fd stav.<\/strong> N\u00e1hl\u00e1 bolest o\u010d\u00ed, rozmazan\u00e9 vid\u011bn\u00ed nebo zarudl\u00e9 oko mohou signalizovat <strong>akutn\u00ed uzav\u0159en\u00fd glaukom<\/strong>, idiosynkratick\u00e1 reakce v prvn\u00edch 1\u20132 t\u00fddnech. L\u00e9k vysa\u010fte a vyhledejte t\u00e9ho\u017e dne o\u010dn\u00ed vy\u0161et\u0159en\u00ed.<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky p\u0159\u00edpravku Topaz<\/h2>\n<p><strong>\u010cast\u00e9 (\u010dasto z\u00e1visl\u00e9 na d\u00e1vce, mohou ustoupit):<\/strong><\/p>\n<ul>\n<li>Parest\u00e9zie (brn\u011bn\u00ed prst\u016f, prst\u016f u nohou, obli\u010deje) \u2014 velmi charakteristick\u00e9, \u010dasto z\u00e1visl\u00e9 na d\u00e1vce, n\u011bkdy ustoup\u00ed, n\u011bkdy p\u0159etrv\u00e1v\u00e1<\/li>\n<li>Zpomalen\u00e9 my\u0161len\u00ed, obt\u00ed\u017ee s vybavov\u00e1n\u00edm slov (lidov\u00fd n\u00e1zev \u201cdopamax\u201d)<\/li>\n<li>Ospalost, \u00fanava<\/li>\n<li>Z\u00e1vrat\u011b<\/li>\n<li>\u00dabytek hmotnosti (\u010dasto vn\u00edman\u00fd jako benefit; pr\u016fm\u011brn\u011b 1,5\u20135 kg za 6 m\u011bs\u00edc\u016f)<\/li>\n<li>Nechutenstv\u00ed, poruchy chuti (sycen\u00e9 n\u00e1poje mohou chutnat mdle nebo kovov\u011b)<\/li>\n<li>Nevolnost<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale d\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li>Poruchy n\u00e1lady \u2014 deprese, \u00fazkost, podr\u00e1\u017ed\u011bnost (5\u201310 %)<\/li>\n<li>Ledvinov\u00e9 kameny (1,5 % \u2014 2\u20134\u00d7 vy\u0161\u0161\u00ed ne\u017e b\u011b\u017en\u00e1 populace). Obvykle jde o kameny z fosfore\u010dnanu v\u00e1penat\u00e9ho zp\u016fsoben\u00e9 alkalizac\u00ed mo\u010di.<\/li>\n<li>Metabolick\u00e1 acid\u00f3za \u2014 hyperchloremick\u00e1, m\u00edrn\u00e1, ale klinicky v\u00fdznamn\u00e1 p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed; kontrolujte bikarbon\u00e1t ro\u010dn\u011b<\/li>\n<li>Hypohidr\u00f3za (sn\u00ed\u017een\u00e9 pocen\u00ed) a hypertermie \u2014 zejm\u00e9na u d\u011bt\u00ed v hork\u00e9m podneb\u00ed<\/li>\n<li>Sn\u00ed\u017een\u00e9 libido nebo sexu\u00e1ln\u00ed funkce<\/li>\n<li>T\u0159es<\/li>\n<\/ul>\n<p><strong>Vz\u00e1cn\u00e9, ale vy\u017eaduje neodkladnou p\u00e9\u010di:<\/strong><\/p>\n<ul>\n<li><strong>Akutn\u00ed glaukom s uzav\u0159en\u00fdm \u00fahlem<\/strong> \u2014 n\u00e1hl\u00e1 bolest o\u010d\u00ed, rozmazan\u00e9 vid\u011bn\u00ed, zarudl\u00e9 oko v prvn\u00edch 1\u20132 t\u00fddnech. P\u0159eru\u0161te pod\u00e1v\u00e1n\u00ed l\u00e9ku, stejn\u00fd den nav\u0161tivte oftalmologii. M\u016f\u017ee zp\u016fsobit trvalou ztr\u00e1tu zraku.<\/li>\n<li><strong>Sebevra\u017eedn\u00e9 my\u0161lenky<\/strong> \u2014 t\u0159\u00eddn\u00ed varov\u00e1n\u00ed pro v\u0161echna antikonvulziva.<\/li>\n<li>Akutn\u00ed myopie \u2014 n\u00e1hl\u00e1 zm\u011bna refrakce souvisej\u00edc\u00ed s mechanismem uzav\u0159en\u00e9ho \u00fahlu<\/li>\n<li>Hyperamonemick\u00e1 encefalopatie \u2014 zvl\u00e1\u0161t\u011b v kombinaci s valpro\u00e1tem<\/li>\n<li>Stevens-Johnson\u016fv syndrom (velmi vz\u00e1cn\u00fd)<\/li>\n<li>T\u011b\u017ek\u00e1 metabolick\u00e1 acid\u00f3za<\/li>\n<li>Tepeln\u00fd \u00fapal souvisej\u00edc\u00ed s oligohidr\u00f3zou (u d\u011bt\u00ed)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a preventivn\u00ed opat\u0159en\u00ed \u2014 KRITICK\u00c9<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed \u2014 FDA kategorie D pro t\u011bhotenstv\u00ed.<\/strong> Topiram\u00e1t v\u00fdrazn\u011b zvy\u0161uje riziko <strong>roz\u0161t\u011bpu rtu a patra<\/strong> p\u0159i expozici v prvn\u00edm trimestru (p\u0159ibli\u017en\u011b 1,4 % u topiram\u00e1tu oproti 0,07 % v z\u00e1kladn\u00ed populaci podle registra\u010dn\u00edch \u00fadaj\u016f \u2014 20n\u00e1sobn\u00e9 relativn\u00ed riziko). Nepou\u017e\u00edvejte k profylaxi migr\u00e9ny u \u017een, kter\u00e9 by mohly ot\u011bhotn\u011bt, pokud selhaly jin\u00e9 mo\u017enosti a nen\u00ed zaji\u0161t\u011bna spolehliv\u00e1 antikoncepce. Doporu\u010duje se fol\u00e1t 5 mg\/den p\u0159i pl\u00e1nov\u00e1n\u00ed t\u011bhotenstv\u00ed s jak\u00fdmkoli antikonvulzivem.<\/li>\n<li><strong>Akutn\u00ed glaukom s uzav\u0159en\u00fdm \u00fahlem<\/strong> \u2014 idiosynkratick\u00e9, v prvn\u00edch 1\u20132 t\u00fddnech. N\u00e1hl\u00e1 bolest o\u010d\u00ed, rozmazan\u00e9 vid\u011bn\u00ed nebo zarudl\u00e9 oko vy\u017eaduje okam\u017eitou oftalmologickou pohotovost.<\/li>\n<li><strong>Kognitivn\u00ed \u00fa\u010dinky<\/strong> \u2014 obt\u00ed\u017ee s vybavov\u00e1n\u00edm slov, zpomalen\u00e9 my\u0161len\u00ed, st\u00ed\u017enosti na pam\u011b\u0165. \u010casto z\u00e1visl\u00e9 na d\u00e1vkov\u00e1n\u00ed; n\u011bkdy limituj\u00edc\u00ed vedlej\u0161\u00ed \u00fa\u010dinek p\u0159i profylaxi migr\u00e9ny. Reverzibiln\u00ed po sn\u00ed\u017een\u00ed d\u00e1vky.<\/li>\n<li><strong>Metabolick\u00e1 acid\u00f3za<\/strong> \u2014 chronick\u00e9. Kontrolujte s\u00e9rov\u00fd bikarbon\u00e1t ro\u010dn\u011b; symptomatick\u00e1 acid\u00f3za (hyperventilace, \u00fanava, anorexie) vy\u017eaduje sn\u00ed\u017een\u00ed d\u00e1vky nebo vysazen\u00ed.<\/li>\n<li><strong>Ledvinov\u00e9 kameny<\/strong> \u2014 dostate\u010dn\u00e1 hydratace; vyhn\u011bte se ketogenn\u00edm diet\u00e1m; u opakovan\u00fdch p\u0159\u00edpad\u016f zva\u017ete suplementaci citr\u00e1tu v mo\u010di.<\/li>\n<li><strong>Hyperamonemick\u00e1 encefalopatie<\/strong> p\u0159i kombinaci s valpro\u00e1tem \u2014 kontrolujte hladinu amoniaku p\u0159i rozvoji ospalosti, zmatenosti nebo zvracen\u00ed.<\/li>\n<li><strong>Hypohidr\u00f3za a hypertermie<\/strong> \u2014 zejm\u00e9na u d\u011bt\u00ed v hork\u00e9m prost\u0159ed\u00ed. Sledujte sn\u00ed\u017een\u00e9 pocen\u00ed, prodlou\u017eenou toleranci k vystaven\u00ed teplu.<\/li>\n<li><strong>Interakce s kombinovanou hormon\u00e1ln\u00ed antikoncepc\u00ed<\/strong> \u2014 topiram\u00e1t &gt;200 mg\/den sni\u017euje hladinu estrogenu o ~30%; nad 200 mg\/den zva\u017ete antikoncepci s vy\u0161\u0161\u00edm obsahem estrogenu nebo alternativn\u00ed metodu.<\/li>\n<li><strong>Sebevra\u017eedn\u00e9 my\u0161lenky<\/strong> \u2014 varov\u00e1n\u00ed pro celou t\u0159\u00eddu l\u00e9k\u016f. Informujte l\u00e9ka\u0159e o jak\u00e9koli nov\u00e9 zm\u011bn\u011b n\u00e1lady.<\/li>\n<li><strong>Nikdy nevysazujte n\u00e1hle<\/strong> p\u0159i epilepsii \u2014 rebound z\u00e1chvaty.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace \u2014 Kdo by NEM\u011aL u\u017e\u00edvat Topaz<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na topiram\u00e1t nebo jakoukoli pomocnou l\u00e1tku tablety<\/li>\n<li>T\u011bhotenstv\u00ed p\u0159i pou\u017eit\u00ed k profylaxi migr\u00e9ny (vyvarovat se; absolutn\u00ed riziko roz\u0161t\u011bpu patra)<\/li>\n<li>T\u011b\u017ek\u00e1 metabolick\u00e1 acid\u00f3za v\u00fdchoz\u00ed<\/li>\n<li>Aktivn\u00ed akutn\u00ed glaukom s uzav\u0159en\u00fdm \u00fahlem<\/li>\n<li>Historie recidivuj\u00edc\u00edho onemocn\u011bn\u00ed ledvinov\u00fdch kamen\u016f z v\u00e1pn\u00edku (relativn\u00ed; nutn\u00fd odborn\u00fd posudek)<\/li>\n<li>D\u011bti &lt;2 roky pro parci\u00e1ln\u00ed z\u00e1chvaty; &lt;12 let pro profylaxi migr\u00e9ny<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Kombinujte s<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u00da\u010dinek<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Co d\u011blat<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Valpro\u00e1t sodn\u00fd<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Riziko hyperamonemick\u00e9 encefalopatie a hypotermie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zkontrolujte hladinu amoniaku, pokud se objev\u00ed p\u0159\u00edznaky. Vyhn\u011bte se kombinaci, pokud existuj\u00ed alternativy.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kombinovan\u00e9 peror\u00e1ln\u00ed antikoncepce<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Topiram\u00e1t &gt;200 mg\/den sni\u017euje hladinu estrogenu p\u0159ibli\u017en\u011b o 30 %<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zva\u017ete pilulku s vy\u0161\u0161\u00edm obsahem estrogenu, alternativn\u00ed antikoncepci nebo bari\u00e9rovou z\u00e1lohu. D\u00e1vky \u2264200 mg\/den jsou obecn\u011b kompatibiln\u00ed.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Karbamazepin, fenytoin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sni\u017euj\u00ed hladinu topiram\u00e1tu (indukce enzym\u016f)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">D\u00e1vku topiram\u00e1tu m\u016f\u017ee b\u00fdt nutn\u00e9 zv\u00fd\u0161it. Sledujte \u00fa\u010dinek.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Lithium<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Topiram\u00e1t m\u016f\u017ee zv\u00fd\u0161it hladinu lithia (ren\u00e1ln\u00ed mechanismus)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sledujte hladinu lithia pe\u010dliv\u011bji.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Acetazolamid, dichlorfenamid<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aditivn\u00ed inhibice karboanhydr\u00e1zy \u2013 metabolick\u00e1 acid\u00f3za, ledvinov\u00e9 kameny<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyhn\u011bte se kombinaci.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Metformin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Topiram\u00e1t m\u016f\u017ee zhor\u0161it metabolickou acid\u00f3zu s metforminem<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sledujte; oba p\u0159isp\u00edvaj\u00ed k acid\u00f3ze.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Alkohol<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aditivn\u00ed \u00fatlum CNS a kognitivn\u00ed poruchy<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Alkohol zcela omezte p\u0159i u\u017e\u00edv\u00e1n\u00ed Topazu.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Phentermine<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Dodate\u010dn\u00fd \u00fabytek hmotnosti (kombinace Qsymia\u00ae), zv\u00fd\u0161en\u00fd krevn\u00ed tlak<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pod odborn\u00fdm dohledem; nejde o b\u011b\u017enou kombinaci.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Hydrochlorothiazid<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zvy\u0161uje hladinu topiram\u00e1tu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sledujte ne\u017e\u00e1douc\u00ed \u00fa\u010dinky topiram\u00e1tu po zah\u00e1jen\u00ed u\u017e\u00edv\u00e1n\u00ed HCTZ.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Pokyny k uchov\u00e1v\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, <strong>15\u201330\u00b0C<\/strong>. Chra\u0148te p\u0159ed vlhkost\u00ed.<\/li>\n<li>Tablety uchov\u00e1vejte v p\u016fvodn\u00edm blistru a\u017e do pou\u017eit\u00ed.<\/li>\n<li>Neskladujte v koupeln\u011b \u2013 vlhkost zkracuje trvanlivost.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/li>\n<li>Nepou\u017e\u00edvejte po uplynut\u00ed data expirace.<\/li>\n<li>Nepou\u017eit\u00e9 tablety vra\u0165te do l\u00e9k\u00e1rny k odborn\u00e9 likvidaci.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy na MedsBase<\/h2>\n<p>Dal\u0161\u00ed l\u00e9ky skladem pro souvisej\u00edc\u00ed stavy:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/neurological-conditions-and-epilepsy\/\">Prohl\u00e9dn\u011bte si v\u0161echny neurologick\u00e9 a antiepileptick\u00e9 l\u00e9ky<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anti-migraine\/\">Prohl\u00e9dn\u011bte si l\u00e9ky proti migr\u00e9n\u011b<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/mental-health-and-psychiatric-medications\/\">Proch\u00e1zejte l\u00e9ky na du\u0161evn\u00ed zdrav\u00ed a psychiatrick\u00e9 l\u00e9ky<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d Topaz zp\u016fsobuje brn\u011bn\u00ed v prstech a obli\u010deji?<\/h3>\n<p>Parest\u00e9zie (brn\u011bn\u00ed) je <strong>p\u0159\u00edm\u00fd \u00fa\u010dinek inhibice karboanhydr\u00e1zy topiram\u00e1tem<\/strong> na perifern\u00ed nervy a je hl\u00e1\u0161ena u 30\u201350 % pacient\u016f b\u011bhem titrace. Obvykle je m\u00edrn\u00e1 a z\u00e1vis\u00ed na d\u00e1vce; n\u011bkte\u0159\u00ed pacienti si zvyknou b\u011bhem 4\u20138 t\u00fddn\u016f, jin\u00ed ji nad\u00e1le poci\u0165uj\u00ed. Potraviny bohat\u00e9 na drasl\u00edk (ban\u00e1ny, avok\u00e1do, fazole) n\u011bkdy pom\u00e1haj\u00ed. Pokud je parest\u00e9zie siln\u00e1 nebo p\u0159etrv\u00e1v\u00e1, standardn\u00ed reakc\u00ed je sn\u00ed\u017een\u00ed d\u00e1vky.<\/p>\n<h3 class=\"wp-block-heading\">Pom\u016f\u017ee mi Topaz skute\u010dn\u011b s migr\u00e9nami?<\/h3>\n<p>Topiram\u00e1t je jedn\u00edm z nejl\u00e9pe v\u011bdecky podlo\u017een\u00fdch profylaktik migr\u00e9ny. Kl\u00ed\u010dov\u00e9 studie uk\u00e1zaly pr\u016fm\u011brn\u00e9 <strong>100 mg\/den<\/strong> 50% sn\u00ed\u017een\u00ed po\u010dtu migr\u00e9nov\u00fdch dn\u016f m\u011bs\u00ed\u010dn\u011b <strong>u p\u0159ibli\u017en\u011b 50 % pacient\u016f, kte\u0159\u00ed jej toleruj\u00ed. \u00dapln\u00fd \u00fa\u010dinek nast\u00e1v\u00e1 za 4\u20138 t\u00fddn\u016f. To d\u011bl\u00e1<\/strong> in approximately 50% of patients who tolerate it. Full effect takes 4\u20138 weeks. It does <em>ne<\/em> zastavit migr\u00e9nu uprost\u0159ed z\u00e1chvatu \u2014 to je \u00faloha triptan\u016f, NSAID nebo gepant\u016f. Realistick\u00fdm c\u00edlem je m\u00e9n\u011b z\u00e1chvat\u016f za m\u011bs\u00edc, ne nulov\u00fd po\u010det.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d Topaz zp\u016fsobuje zpomalen\u00ed kognitivn\u00edch funkc\u00ed?<\/h3>\n<p>Topiram\u00e1t <strong>kombinovan\u00fdm p\u016fsoben\u00edm na glutam\u00e1t, GABA a karboanhydr\u00e1zu<\/strong> zpomaluje zpracov\u00e1n\u00ed jazyka a pracovn\u00ed pam\u011b\u0165. Klasickou st\u00ed\u017enost\u00ed je obt\u00ed\u017en\u00e9 hled\u00e1n\u00ed slov (\u201cm\u00e1m to na jazyku\u201d). Tento efekt je <strong>z\u00e1visl\u00fd na d\u00e1vce a reverzibiln\u00ed<\/strong>: d\u00e1vky pod 100 mg\/den maj\u00ed u v\u011bt\u0161iny lid\u00ed minim\u00e1ln\u00ed kognitivn\u00ed \u00fa\u010dinky; d\u00e1vky &gt;200 mg\/den zp\u016fsobuj\u00ed u mnoha pacient\u016f znateln\u00e9 zpomalen\u00ed. Pom\u00e1h\u00e1 pomal\u00e1 titrace.<\/p>\n<h3 class=\"wp-block-heading\">Je Topaz bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n<p><strong>Ne \u2014 topiram\u00e1t je prok\u00e1zan\u00fd teratogen.<\/strong> Expozice v prvn\u00edm trimestru zvy\u0161uje riziko <strong>roz\u0161t\u011bpu rtu a patra p\u0159ibli\u017en\u011b 20kr\u00e1t<\/strong> oproti z\u00e1kladn\u00edmu riziku (~1,4% absolutn\u00ed riziko). Topiram\u00e1t by nem\u011bl b\u00fdt pou\u017e\u00edv\u00e1n k profylaxi migr\u00e9ny u \u017een, kter\u00e9 by mohly ot\u011bhotn\u011bt, pokud jin\u00e9 mo\u017enosti selhaly a je prok\u00e1z\u00e1na spolehliv\u00e1 antikoncepce. U epilepsie je rozhodov\u00e1n\u00ed slo\u017eit\u011bj\u0161\u00ed \u2014 je nezbytn\u00fd odborn\u00fd posudek. Doporu\u010duje se fol\u00e1t 5 mg\/den p\u0159i pl\u00e1nov\u00e1n\u00ed t\u011bhotenstv\u00ed s antikonvulzivy.<\/p>\n<h3 class=\"wp-block-heading\">Zp\u016fsob\u00ed Topaz \u00fabytek hmotnosti?<\/h3>\n<p><strong>Ano, u mnoha pacient\u016f.<\/strong> Topiram\u00e1t v pr\u016fm\u011bru zp\u016fsob\u00ed \u00fabytek hmotnosti o <strong>1,5\u20135 kg za 6 m\u011bs\u00edc\u016f<\/strong>, zp\u016fsobeno sn\u00ed\u017een\u00edm chuti k j\u00eddlu, zm\u011bnou chuti (sycen\u00e9 n\u00e1poje chutnaj\u00ed mdle) a metabolick\u00fdmi \u00fa\u010dinky inhibice karboanhydr\u00e1zy. Je sou\u010d\u00e1st\u00ed schv\u00e1len\u00e9ho l\u00e9ku na obezitu Qsymia\u00ae (topiram\u00e1t + fentermin). \u00dabytek hmotnosti je obvykle v\u00edt\u00e1n u pacient\u016f s migr\u00e9nou a epilepsi\u00ed, ale znamen\u00e1, \u017ee podv\u00e1hov\u00ed jedinci pot\u0159ebuj\u00ed pe\u010dliv\u00e9 sledov\u00e1n\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d mus\u00edm na Topazu p\u00edt tolik vody?<\/h3>\n<p>Topiram\u00e1t zp\u016fsobuje <strong>alkalizaci mo\u010di a sn\u00ed\u017eenou exkreci citr\u00e1tu v mo\u010di<\/strong>, co\u017e spole\u010dn\u011b zvy\u0161uje riziko vzniku v\u00e1penato-fosf\u00e1tov\u00fdch ledvinov\u00fdch kamen\u016f (~1,5 %, oproti z\u00e1kladn\u00edmu riziku 0,5 %). Dostate\u010dn\u00e1 hydratace (2\u20133 l\/den, v\u00edce v horku) udr\u017euje mo\u010d z\u0159ed\u011bnou a sni\u017euje riziko vzniku kamen\u016f. Vyhn\u011bte se ketogenn\u00ed a Atkinsov\u011b diet\u011b \u2014 kombinace n\u00edzkosacharidov\u00e9 stravy a topiram\u00e1tu v\u00fdrazn\u011b zvy\u0161uje acid\u00f3zu a tvorbu kamen\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Na co upozor\u0148uje varov\u00e1n\u00ed o o\u010d\u00edch?<\/h3>\n<p>Topiram\u00e1t m\u016f\u017ee zp\u016fsobit <strong>idiosynkratick\u00fd akutn\u00ed uzav\u0159en\u00fd glaukom<\/strong>, obvykle v prvn\u00edch 1\u20132 t\u00fddnech. P\u0159\u00edznaky: n\u00e1hl\u00e1 bolest oka, rozmazan\u00e9 vid\u011bn\u00ed, zarudl\u00e9 oko, nevolnost. <strong>Jedn\u00e1 se o o\u010dn\u00ed pohotovost vy\u017eaduj\u00edc\u00ed stejn\u00fd den z\u00e1sah.<\/strong> Nel\u00e9\u010den\u00fd stav m\u016f\u017ee do 24\u201348 hodin zp\u016fsobit trvalou ztr\u00e1tu zraku. L\u00e9k okam\u017eit\u011b vysa\u010fte a vyhledejte p\u00e9\u010di \u2014 ne\u010dekejte na b\u011b\u017enou objedn\u00e1vku.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee Topaz nahradit mou antikoncep\u010dn\u00ed pilulku?<\/h3>\n<p><strong>Ne.<\/strong> Topiram\u00e1t nen\u00ed antikoncepce; ve skute\u010dnosti p\u0159i d\u00e1vk\u00e1ch nad <strong>200 mg\/den<\/strong> sni\u017euje hladinu estrogenu v kombinovan\u00fdch hormon\u00e1ln\u00edch antikoncepc\u00edch p\u0159ibli\u017en\u011b o 30 %, co\u017e m\u016f\u017ee sn\u00ed\u017eit \u00fa\u010dinnost pilulek. Pokud u\u017e\u00edv\u00e1te antikoncepci, proberte to se sv\u00fdm l\u00e9ka\u0159em: d\u00e1vky do 200 mg\/den jsou obvykle kompatibiln\u00ed; vy\u0161\u0161\u00ed d\u00e1vky mohou vy\u017eadovat pilulku s vy\u0161\u0161\u00edm obsahem estrogenu nebo alternativn\u00ed metodu. D\u00e1vky pro migr\u00e9nu (50\u2013100 mg\/den) tento probl\u00e9m z\u0159\u00eddka zp\u016fsobuj\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed p\u0159\u00edpravku Topaz?<\/h3>\n<p>Lehk\u00e9 pit\u00ed alkoholu je obvykle tolerov\u00e1no, ale kombinace m\u00e1 aditivn\u00ed \u00fa\u010dinky: v\u011bt\u0161\u00ed zpomalen\u00ed kognitivn\u00edch funkc\u00ed, v\u011bt\u0161\u00ed ospalost, v\u011bt\u0161\u00ed poruchy pam\u011bti. Topiram\u00e1t se n\u011bkdy <em>pou\u017e\u00edv\u00e1<\/em> mimo schv\u00e1len\u00e9 indikace ke sn\u00ed\u017een\u00ed chuti na alkohol p\u0159i poru\u0161e u\u017e\u00edv\u00e1n\u00ed alkoholu, ale to neznamen\u00e1, \u017ee pit\u00ed alkoholu b\u011bhem l\u00e9\u010dby je bezpe\u010dn\u00e9. Zcela se vyhn\u011bte n\u00e1razov\u00e9mu pit\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Jak bezpe\u010dn\u011b vysadit p\u0159\u00edpravek Topaz?<\/h3>\n<p>Sni\u017eujte d\u00e1vku o <strong>25\u201350 mg ka\u017ed\u00fdch 1\u20132 t\u00fddny<\/strong> p\u0159i profylaxi migr\u00e9ny; pomaleji u epilepsie pod dohledem neurologa. N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat rebound z\u00e1chvaty (epilepsii) nebo rebound migr\u00e9nu. Kognitivn\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky \u010dasto vymiz\u00ed b\u011bhem 4\u20138 t\u00fddn\u016f po vysazen\u00ed; hmotnost se m\u016f\u017ee postupn\u011b vr\u00e1tit.<\/p>\n<h3 class=\"wp-block-heading\">Kde se p\u0159\u00edpravek Topaz vyr\u00e1b\u00ed?<\/h3>\n<p>Topaz je dod\u00e1v\u00e1n spole\u010dnost\u00ed <strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong> a je bioekvivalentn\u00ed origin\u00e1ln\u00ed zna\u010dce Topamax\u00ae (Janssen) ve stejn\u00e9 miligramov\u00e9 s\u00edle. Certifik\u00e1ty \u0161ar\u017e\u00ed jsou k dispozici na vy\u017e\u00e1d\u00e1n\u00ed.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/combutol\/\">Combutol<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/simvotin\/\">Simvotin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/salazar\/\">Salazar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/hydrosar\/\">Hydrosar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/wysolone\/\">Wysolone<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Sni\u017euje frekvenci z\u00e1chvat\u016f<br \/>\n\u2705 Kontroluje migr\u00e9ny<br \/>\n\u2705 L\u00e9\u010d\u00ed bipol\u00e1rn\u00ed poruchu<br \/>\n\u2705 L\u00e9\u010d\u00ed neuropatickou bolest<br \/>\n\u2705 Pom\u00e1h\u00e1 p\u0159i hubnut\u00ed<\/p>\n<p>P\u0159\u00edpravek Topaz obsahuje topiram\u00e1t.<\/p>","protected":false},"featured_media":52181,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3468],"product_tag":[3469,3467],"class_list":{"0":"post-52180","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-neurological-conditions-and-epilepsy","9":"product_tag-topaz","10":"product_tag-topiramate","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/52180","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=52180"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/52181"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=52180"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=52180"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=52180"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=52180"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}