{"id":61175,"date":"2024-02-28T07:27:59","date_gmt":"2024-02-28T07:27:59","guid":{"rendered":"https:\/\/medsname.com\/topicon\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"topicon","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/topicon\/","title":{"rendered":"Topicon"},"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 Topicon?<\/h3>\n<p style=\"margin:0;\"><strong>Topicon<\/strong> obsahuje <strong>topiram\u00e1t 50 mg \/ 100 mg<\/strong> tablety od spole\u010dnosti Intas Pharmaceuticals \u2014 sulfam\u00e1tem substituovan\u00fd monosacharidov\u00fd antikonvulzivum \u0161iroce pou\u017e\u00edvan\u00fd jako <strong>l\u00e9k prvn\u00ed volby pro prevenci migr\u00e9ny<\/strong> u dosp\u011bl\u00fdch. Tak\u00e9 schv\u00e1len pro fok\u00e1ln\u00ed a generalizovanou epilepsii; pou\u017e\u00edv\u00e1 se off-label pro esenci\u00e1ln\u00ed tremor, poruchu p\u0159ej\u00edd\u00e1n\u00ed a poruchu u\u017e\u00edv\u00e1n\u00ed alkoholu. Typick\u00e1 d\u00e1vka pro prevenci migr\u00e9ny: <strong>za\u010dn\u011bte s 25 mg na noc po dobu 1 t\u00fddne, pot\u00e9 titrujte o 25 mg t\u00fddn\u011b na c\u00edlovou d\u00e1vku 100 mg\/den ve dvou d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch<\/strong> (rozmez\u00ed 50-200 mg\/den). \u00dapln\u00fd efekt za 8-12 t\u00fddn\u016f. Sni\u017euje frekvenci migr\u00e9ny p\u0159ibli\u017en\u011b o 50% u asi poloviny l\u00e9\u010den\u00fdch pacient\u016f (studie PROMPT, MIGR-001, MIGR-002). Kl\u00ed\u010dov\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: <strong>parest\u00e9zie (mraven\u010den\u00ed) u 50%<\/strong>, kognitivn\u00ed otup\u011blost \/ obt\u00ed\u017ee s hled\u00e1n\u00edm slov (\u201ctopa-max\u201d efekt), \u00fabytek hmotnosti (\u010dasto v\u00edtan\u00fd), metabolick\u00e1 acid\u00f3za, ledvinov\u00e9 kameny a \u2014 d\u016fle\u017eit\u00e9 pro \u017eeny \u2014 <strong>riziko roz\u0161t\u011bpu rtu\/patra v prvn\u00edm trimestru t\u011bhotenstv\u00ed a sn\u00ed\u017een\u00e1 \u00fa\u010dinnost kombinovan\u00fdch peror\u00e1ln\u00edch kontraceptiv p\u0159i d\u00e1vk\u00e1ch &gt;200 mg\/den<\/strong>.<\/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<h2 class=\"wp-block-heading\">Co je Topicon?<\/h2>\n<p>Topicon je peror\u00e1ln\u00ed tableta <strong>topiram\u00e1t 50 mg \/ 100 mg<\/strong> od spole\u010dnosti Intas Pharmaceuticals, dod\u00e1van\u00e1 v balen\u00edch po 30-180 tablet\u00e1ch. Topiram\u00e1t je sulfam\u00e1tem substituovan\u00fd monosacharid p\u016fvodn\u011b vyvinut\u00fd a uv\u00e1d\u011bn\u00fd na trh spole\u010dnost\u00ed Johnson &amp; Johnson jako <strong>Topamax<\/strong>; st\u00e1le pat\u0159\u00ed mezi dva peror\u00e1ln\u00ed l\u00e9ky schv\u00e1len\u00e9 FDA pro prevenci migr\u00e9ny u dosp\u011bl\u00fdch (spolu s propranololem, divalproexem, timololem).<\/p>\n<h2 class=\"wp-block-heading\">Jak topiram\u00e1t p\u0159edch\u00e1z\u00ed migr\u00e9n\u011b<\/h2>\n<p>P\u0159esn\u00fd mechanismus v profylaxi migr\u00e9ny je multimod\u00e1ln\u00ed a nen\u00ed pln\u011b objasn\u011bn, ale n\u011bkolik soub\u011b\u017en\u00fdch \u00fa\u010dink\u016f vysv\u011btluje jeho p\u016fsoben\u00ed:<\/p>\n<ul>\n<li><strong>Blok\u00e1da nap\u011b\u0165ov\u011b \u0159\u00edzen\u00fdch sod\u00edkov\u00fdch kan\u00e1l\u016f<\/strong> \u2014 sni\u017euje neuron\u00e1ln\u00ed hyperexcitabilitu v nucleus caudalis trigeminu<\/li>\n<li><strong>Potenciace aktivity GABA-A receptor\u016f<\/strong> \u2014 zesiluje inhibi\u010dn\u00ed tonus<\/li>\n<li><strong>Antagonismus AMPA\/kain\u00e1tov\u00fdch glutam\u00e1tov\u00fdch receptor\u016f<\/strong> \u2014 sni\u017euje excita\u010dn\u00ed p\u0159enos<\/li>\n<li><strong>Inhibice karboanhydr\u00e1zy<\/strong> (izoformy II a IV) \u2014 zodpov\u011bdn\u00e9 za vedlej\u0161\u00ed \u00fa\u010dinek metabolick\u00e9 acid\u00f3zy a mo\u017en\u00e1 i za \u010d\u00e1st antimigren\u00f3zn\u00edho \u00fa\u010dinku prost\u0159ednictv\u00edm prahu kortik\u00e1ln\u00ed \u0161\u00ed\u0159\u00edc\u00ed se deprese<\/li>\n<li>Potla\u010den\u00ed <strong>kortik\u00e1ln\u00ed \u0161\u00ed\u0159\u00edc\u00ed se deprese<\/strong> \u2014 patofyziologick\u00fd substr\u00e1t migr\u00e9nov\u00e9 aury<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n<ul>\n<li><strong>Profylaxe migr\u00e9ny u dosp\u011bl\u00fdch<\/strong> \u2014 schv\u00e1leno FDA v roce 2004 na z\u00e1klad\u011b studi\u00ed MIGR-001 a MIGR-002. ~50% redukce m\u011bs\u00ed\u010dn\u00edch migr\u00e9nov\u00fdch dn\u016f u poloviny l\u00e9\u010den\u00fdch pacient\u016f p\u0159i d\u00e1vce 100 mg\/den.<\/li>\n<li><strong>Profylaxe migr\u00e9ny u adolescent\u016f 12+<\/strong> \u2014 roz\u0161\u00ed\u0159en\u00ed indikace FDA 2014<\/li>\n<li><strong>Chronick\u00e1 migr\u00e9na<\/strong> \u2014 \u00fa\u010dinn\u00e9 u pacient\u016f s \u226515 dny bolesti hlavy\/m\u011bs\u00edc, z toho 8+ migren\u00f3zn\u00edch (Silberstein 2007)<\/li>\n<li><strong>Epilepsie<\/strong> \u2014 fok\u00e1ln\u00ed z\u00e1chvaty, generalizovan\u00e9 tonicko-klonick\u00e9, Lennox-Gastaut\u016fv syndrom<\/li>\n<li><strong>Obezita (mimo indikaci)<\/strong> \u2014 jako sou\u010d\u00e1st p\u0159\u00edpravku Qsymia (fentermin + topiram\u00e1t)<\/li>\n<li><strong>Esenci\u00e1ln\u00ed tremor, porucha p\u0159\u00edjmu potravy s epizodami p\u0159ej\u00edd\u00e1n\u00ed, porucha u\u017e\u00edv\u00e1n\u00ed alkoholu, profylaxe cluster headache<\/strong> \u2014 neschv\u00e1len\u00e9 pou\u017eit\u00ed, prom\u011bnliv\u00e1 m\u00edra d\u016fkaz\u016f<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed p\u0159\u00edpravku Topicon pro prevenci migr\u00e9ny<\/h2>\n<p>Topiram\u00e1t se <strong>pomalu titruje<\/strong> aby se minimalizovaly kognitivn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky \u2014 rychl\u00e9 zvy\u0161ov\u00e1n\u00ed d\u00e1vky je nej\u010dast\u011bj\u0161\u00edm d\u016fvodem, pro\u010d pacienti l\u00e9\u010dbu ukon\u010duj\u00ed.<\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">T\u00fdden<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">R\u00e1no<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Ve\u010der<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Celkov\u00e1 denn\u00ed d\u00e1vka<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">T\u00fdden 1<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u2014<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">25 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">25 mg<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">T\u00fdden 2<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">25 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">25 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">50 mg<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">T\u00fdden 3<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">25 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">50 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">75 mg<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">T\u00fdden 4+<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">50 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">50 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>100 mg (c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed)<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>C\u00edlov\u00e1 d\u00e1vka:<\/strong> 100 mg\/den ve dvou rozd\u011blen\u00fdch d\u00e1vk\u00e1ch. P\u0159i \u010d\u00e1ste\u010dn\u00e9 odpov\u011bdi lze d\u00e1vku zv\u00fd\u0161it na 200 mg\/den, ale nad 100 mg\/den v\u00fdrazn\u011b stoup\u00e1 v\u00fdskyt vedlej\u0161\u00edch \u00fa\u010dink\u016f bez \u00fam\u011brn\u00e9ho p\u0159\u00ednosu.<\/p>\n<p><strong>Vyhodno\u0165te \u00fa\u010dinek za 8-12 t\u00fddn\u016f.<\/strong> Zaznamen\u00e1vejte po\u010det dn\u016f s migr\u00e9nou m\u011bs\u00ed\u010dn\u011b p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby a ve 12. t\u00fddnu; pokra\u010dujte, pokud dojde k &gt;50% sn\u00ed\u017een\u00ed. P\u0159i absenci odpov\u011bdi na 200 mg\/den po 12 t\u00fddnech p\u0159ejd\u011bte na jin\u00fd p\u0159\u00edpravek.<\/p>\n<p><strong>Ukon\u010den\u00ed l\u00e9\u010dby:<\/strong> postupn\u00e9 vysazov\u00e1n\u00ed b\u011bhem 2-4 t\u00fddn\u016f (sni\u017eovat o 25 mg ka\u017ed\u00e9 3-5 dn\u00ed) \u2014 n\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat rebound migr\u00e9nu a ve vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch i z\u00e1chvat. Pokud u\u017e\u00edv\u00e1te topiram\u00e1t \u22651 rok, zva\u017ete 4t\u00fddenn\u00ed vysazov\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>Velmi \u010dast\u00e9 (&gt;10 %):<\/strong><\/p>\n<ul>\n<li><strong>Parest\u00e9zie<\/strong> (mraven\u010den\u00ed, obvykle v rukou a nohou) \u2014 50%. \u010casto reaguje na dietu bohatou na drasl\u00edk nebo n\u00edzkou d\u00e1vku citronanu draseln\u00e9ho.<\/li>\n<li><strong>Kognitivn\u00ed \u00fa\u010dinky<\/strong> \u2014 obt\u00ed\u017ee s hled\u00e1n\u00edm slov, v\u00fdpadky pam\u011bti, zpomalen\u00e9 my\u0161len\u00ed (lidov\u011b \u201ctopa-max\u201d). Z\u00e1visl\u00e9 na d\u00e1vce a \u010dasto reverzibiln\u00ed po vysazen\u00ed.<\/li>\n<li><strong>\u00dabytek hmotnosti<\/strong> (\u00fabytek 5-10% t\u011blesn\u00e9 hmotnosti b\u011b\u017en\u00fd; n\u011bkte\u0159\u00ed to pova\u017euj\u00ed za v\u00fdhodu)<\/li>\n<li>\u00danava, ospalost, z\u00e1vrat\u011b<\/li>\n<li>Zm\u011bna chuti (zejm\u00e9na sycen\u00e9 n\u00e1poje chutnaj\u00ed nev\u00fdrazn\u011b)<\/li>\n<li>Nevolnost, sn\u00ed\u017een\u00e1 chu\u0165 k j\u00eddlu<\/li>\n<\/ul>\n<p><strong>B\u011b\u017en\u00e9 (1-10 %):<\/strong> deprese, \u00fazkost, podr\u00e1\u017ed\u011bnost, pot\u00ed\u017ee se soust\u0159ed\u011bn\u00edm, nespavost, pr\u016fjem.<\/p>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale d\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Ledvinov\u00e9 kameny<\/strong> (1,5% ro\u010dn\u00ed riziko; inhibice karboanhydr\u00e1zy zp\u016fsobuje hypokitraturii). Udr\u017eujte dobrou hydrataci; suplementace citr\u00e1tem draseln\u00fdm sni\u017euje riziko.<\/li>\n<li><strong>Metabolick\u00e1 acid\u00f3za<\/strong> s hyperchloremi\u00ed \u2013 m\u00edrn\u00e9, obvykle asymptomatick\u00e9; probl\u00e9m u pacient\u016f s ren\u00e1ln\u00edm onemocn\u011bn\u00edm<\/li>\n<li><strong>Oligohidr\u00f3za<\/strong> (sn\u00ed\u017een\u00e9 pocen\u00ed) a hypertermie \u2013 zejm\u00e9na u d\u011bt\u00ed v hork\u00e9m podneb\u00ed<\/li>\n<li><strong>Akutn\u00ed glaukom s uzav\u0159en\u00fdm \u00fahlem<\/strong> \u2013 vz\u00e1cn\u00e9, ale potenci\u00e1ln\u011b ohro\u017euj\u00edc\u00ed zrak; typicky v prvn\u00edm m\u011bs\u00edci terapie. P\u0159i bolesti o\u010d\u00ed nebo zm\u011bn\u00e1ch vid\u011bn\u00ed vyhledejte neodkladnou o\u010dn\u00ed konzultaci.<\/li>\n<li><strong>\u00da\u010dinky na n\u00e1ladu<\/strong> \u2013 deprese a sebevra\u017eedn\u00e9 my\u0161lenky (t\u0159\u00eddn\u00ed varov\u00e1n\u00ed pro v\u0161echna antiepileptika)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace &amp; Opat\u0159en\u00ed<\/h2>\n<ul>\n<li>P\u0159ecitliv\u011blost na topiram\u00e1t<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed<\/li>\n<li>T\u011b\u017ek\u00e9 ren\u00e1ln\u00ed selh\u00e1n\u00ed (eGFR &lt;30) \u2013 nutn\u00e1 redukce d\u00e1vky o 50 %<\/li>\n<li>T\u011bhotenstv\u00ed \u2013 <strong>topiram\u00e1t zvy\u0161uje riziko roz\u0161t\u011bpu patra\/rtu p\u0159ibli\u017en\u011b 3\u00d7<\/strong> p\u0159i expozici v prvn\u00edm trimestru (3let\u00e1 observa\u010dn\u00ed data z North American AED Pregnancy Registry). Pou\u017e\u00edvejte \u00fa\u010dinnou antikoncepci po celou dobu a 1 m\u011bs\u00edc po vysazen\u00ed. Pokud dojde k ot\u011bhotn\u011bn\u00ed, okam\u017eit\u011b p\u0159ejd\u011bte na preventivn\u00ed l\u00e9\u010dbu.<\/li>\n<li>Anamn\u00e9za ledvinov\u00fdch kamen\u016f (relativn\u00ed kontraindikace)<\/li>\n<li>Uzav\u0159en\u00fd \u00fahel glaukomu<\/li>\n<li>Metabolick\u00e1 acid\u00f3za \/ hydrogenuhli\u010ditan sodn\u00fd &lt;20 mEq\/l<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> FDA kategorie t\u011bhotenstv\u00ed D. Pokud je topiram\u00e1t jedin\u00fdm \u00fa\u010dinn\u00fdm preventivn\u00edm l\u00e9kem a migr\u00e9na je z\u00e1va\u017en\u00e1, zva\u017ete riziko vs. p\u0159\u00ednos s neurologem a porodn\u00edkem \u2014 b\u011bhem t\u011bhotenstv\u00ed se z\u0159\u00eddka pokra\u010duje.<\/p>\n<p><strong>Kojen\u00ed:<\/strong> Topiram\u00e1t p\u0159ech\u00e1z\u00ed do mate\u0159sk\u00e9ho ml\u00e9ka (pom\u011br ml\u00e9ko\/plazma ~0,86). B\u011bhem kojen\u00ed se obecn\u011b nedoporu\u010duje.<\/p>\n<p><strong>Antikoncepce:<\/strong> p\u0159i d\u00e1vk\u00e1ch &gt;200 mg\/den topiram\u00e1t m\u00edrn\u011b sni\u017euje \u00fa\u010dinnost kombinovan\u00e9 peror\u00e1ln\u00ed antikoncepce (indukuje CYP3A4). U\u017e\u00edv\u00e1n\u00ed pouze progestinov\u00e9 pilulky NEN\u00cd dostate\u010dn\u00e9 \u0159e\u0161en\u00ed \u2014 nav\u00edc pou\u017eijte bari\u00e9rovou metodu nebo nitrod\u011blo\u017en\u00ed t\u011bl\u00edsko.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Kombinovan\u00e9 peror\u00e1ln\u00ed antikoncepce<\/strong> \u2014 sn\u00ed\u017een\u00e1 \u00fa\u010dinnost p\u0159i &gt;200 mg\/den; pou\u017eijte nitrod\u011blo\u017en\u00ed t\u011bl\u00edsko nebo bari\u00e9rovou metodu<\/li>\n<li><strong>Inhibitory karboanhydr\u00e1zy<\/strong> (acetazolamid, zonisamid) \u2014 aditivn\u00ed riziko acid\u00f3zy a ledvinov\u00fdch kamen\u016f<\/li>\n<li><strong>Alkohol, benzodiazepiny, opioidy<\/strong> \u2014 kumulativn\u00ed \u00fatlum CNS<\/li>\n<li><strong>Jin\u00e1 antiepileptika<\/strong> \u2014 fenytoin a karbamazepin sni\u017euj\u00ed hladiny topiram\u00e1tu; valpro\u00e1t je neutr\u00e1ln\u00ed<\/li>\n<li><strong>Lithium<\/strong> \u2014 topiram\u00e1t m\u016f\u017ee zv\u00fd\u0161it hladiny lithia<\/li>\n<li><strong>Metformin<\/strong> \u2014 topiram\u00e1t m\u016f\u017ee zm\u011bnit farmakokinetiku metforminu; sledujte hladinu gluk\u00f3zy<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte p\u0159i teplot\u011b do 25\u00b0C v p\u016fvodn\u00edm blistru. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Za jak dlouho za\u010dne Topicon \u00fa\u010dinkovat p\u0159i migr\u00e9n\u011b?<\/h3>\n<p>V\u00fdznamn\u00e9 sn\u00ed\u017een\u00ed frekvence migr\u00e9n je obvykle patrn\u00e9 od <strong>4.\u20138. t\u00fddne<\/strong> jak se d\u00e1vka titruje na c\u00edlovou hodnotu. Pln\u00fd \u00fa\u010dinek nast\u00e1v\u00e1 p\u0159i <strong>8-12 t\u00fddnech<\/strong>. Nevyvozujte z\u00e1v\u011br, \u017ee topiram\u00e1t selhal, dokud nebudete u\u017e\u00edvat 100 mg\/den po dobu alespo\u0148 8 t\u00fddn\u016f s migren\u00f3zn\u00edm den\u00edkem pro srovn\u00e1n\u00ed s v\u00fdchoz\u00edm stavem.<\/p>\n<h3 class=\"wp-block-heading\">Zp\u016fsob\u00ed Topicon \u00fabytek hmotnosti?<\/h3>\n<p>Ano, u p\u0159ibli\u017en\u011b poloviny pacient\u016f. Pr\u016fm\u011brn\u00fd \u00fabytek hmotnosti v studi\u00edch prevence migr\u00e9ny byl 4\u20136 kg za 12 m\u011bs\u00edc\u016f. Mechanismus zahrnuje sn\u00ed\u017eenou chu\u0165 k j\u00eddlu, zm\u011bn\u011bnou chu\u0165 sycen\u00fdch a tu\u010dn\u00fdch j\u00eddel a m\u00edrn\u00e9 metabolick\u00e9 \u00fa\u010dinky. U pacient\u016f s obezitou asociovanou migr\u00e9nou (b\u011b\u017en\u00fd fenotyp) je to \u017e\u00e1douc\u00ed; u pacient\u016f s n\u00edzkou v\u00fdchoz\u00ed hmotnost\u00ed to m\u016f\u017ee b\u00fdt d\u00e1vkov\u011b limituj\u00edc\u00ed probl\u00e9m.<\/p>\n<h3 class=\"wp-block-heading\">Co je \u201ctopamaxov\u00fd\u201d kognitivn\u00ed efekt?<\/h3>\n<p>D\u00e1vkov\u011b z\u00e1visl\u00e9 obt\u00ed\u017ee s hled\u00e1n\u00edm slov, zpomalen\u00e9 my\u0161len\u00ed a m\u00edrn\u00e9 v\u00fdpadky pam\u011bti. Obvykle m\u00edrn\u00e9 p\u0159i 50\u2013100 mg\/den; v\u00fdrazn\u011bj\u0161\u00ed p\u0159i 200+ mg. Reverzibiln\u00ed p\u0159i sn\u00ed\u017een\u00ed d\u00e1vky nebo vysazen\u00ed. Pokud va\u0161e pr\u00e1ce z\u00e1vis\u00ed na verb\u00e1ln\u00ed plynulosti (v\u00fduka, pr\u00e1vo, medic\u00edna, software), upozorn\u011bte p\u0159edepisuj\u00edc\u00edho l\u00e9ka\u0159e a zva\u017ete alternativn\u00ed profylaxi (<a href=\"https:\/\/medsbase.com\/cs\/inderal\/\">propranolol<\/a>, amitriptylin, <a href=\"https:\/\/medsbase.com\/cs\/sibelium\/\">flunarizin<\/a>), pokud kognitivn\u00ed efekt naru\u0161uje funkci.<\/p>\n<h3 class=\"wp-block-heading\">Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed Topiconu?<\/h3>\n<p>M\u00edrn\u00e1 konzumace je obecn\u011b p\u0159ijateln\u00e1, ale alkohol zesiluje sedativn\u00ed a kognitivn\u00ed \u00fa\u010dinky topiram\u00e1tu. Alkohol je tak\u00e9 \u010dast\u00fdm spou\u0161t\u011b\u010dem migr\u00e9ny, tak\u017ee sn\u00ed\u017een\u00ed p\u0159\u00edjmu \u010dasto zlep\u0161uje frekvenci migr\u00e9n nez\u00e1visle na topiram\u00e1tu. Vyhn\u011bte se alkoholu v prvn\u00edch 2\u20134 t\u00fddnech titrace d\u00e1vky, kdy jsou kognitivn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky nejv\u00fdrazn\u011bj\u0161\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Topicon v t\u011bhotenstv\u00ed?<\/h3>\n<p>Ne \u2014 topiram\u00e1t p\u0159ibli\u017en\u011b ztrojn\u00e1sobuje riziko roz\u0161t\u011bpu rtu\/patra v prvn\u00edm trimestru (FDA t\u011bhotensk\u00e1 kategorie D). \u017deny v reproduk\u010dn\u00edm v\u011bku by m\u011bly pou\u017e\u00edvat spolehlivou antikoncepci (nitrod\u011blo\u017en\u00ed t\u011bl\u00edsko, bari\u00e9rov\u00e9 metody; peror\u00e1ln\u00ed antikoncepce m\u016f\u017ee b\u00fdt topiram\u00e1tem sn\u00ed\u017eena p\u0159i d\u00e1vk\u00e1ch &gt;200 mg\/den). P\u0159ed po\u010det\u00edm p\u0159ejd\u011bte na bezpe\u010dn\u011bj\u0161\u00ed preventivn\u00ed l\u00e9k (<a href=\"https:\/\/medsbase.com\/cs\/inderal\/\">propranolol<\/a> nebo amitriptylin jsou v t\u011bhotenstv\u00ed preferov\u00e1ny).<\/p>\n<h3 class=\"wp-block-heading\">Jak vysadit Topicon?<\/h3>\n<p>Vysazujte postupn\u011b \u2014 sni\u017eujte d\u00e1vku o 25-50 mg ka\u017ed\u00fdch 1-2 t\u00fddny po dobu 2-4 t\u00fddn\u016f. N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat rebound migr\u00e9nu a p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch i z\u00e1chvaty (i u pacient\u016f bez epilepsie). Nikdy nevysazujte p\u0159es noc.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017eu u\u017e\u00edvat Topicon s triptanem?<\/h3>\n<p>Ano \u2014 topiram\u00e1t je preventivn\u00ed l\u00e9k a triptany jsou akutn\u00ed l\u00e9\u010dba. P\u016fsob\u00ed r\u016fzn\u00fdmi mechanismy a b\u011b\u017en\u011b se kombinuj\u00ed: topiram\u00e1t denn\u011b ke sn\u00ed\u017een\u00ed frekvence migr\u00e9n, triptan (<a href=\"https:\/\/medsbase.com\/cs\/sumitop\/\">sumatriptan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/maxtan\/\">rizatriptan<\/a>, <a href=\"https:\/\/medsbase.com\/cs\/zolitas-ods\/\">zolmitriptan<\/a>) podle pot\u0159eby p\u0159i akutn\u00edch z\u00e1chvatech.<\/p>\n<h3 class=\"wp-block-heading\">Kde lze koupit Topicon online?<\/h3>\n<p>Topicon (topiram\u00e1t 50 mg \/ 100 mg, balen\u00ed po 30-180 tablet\u00e1ch) m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed l\u00e9\u010dba migr\u00e9ny na MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zolmist-nasal-spray\/\">Zolmist nosn\u00ed sprej \u2014 Zolmitriptan 5 mg (rychlej\u0161\u00ed n\u00e1stup \u00fa\u010dinku)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zolitas-ods\/\">Zolitas ODS \u2014 Zolmitriptan 2,5\/5 mg orodispergovateln\u00e9 tablety<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/maxtan\/\">Maxtan \u2014 Rizatriptan 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rizatop\/\">Rizatop \u2014 Rizatriptan 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rizact\/\">Rizact \u2014 Rizatriptan (Cipla)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/sumitop\/\">Sumitop \u2014 Sumatriptan 25\/50\/100 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/anti-migraine\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky proti migr\u00e9n\u011b<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje odbornou l\u00e9ka\u0159skou pomoc. P\u0159ed zah\u00e1jen\u00edm, zm\u011bnou nebo ukon\u010den\u00edm jak\u00e9hokoli l\u00e9\u010den\u00ed migr\u00e9ny se v\u017edy pora\u010fte se sv\u00fdm l\u00e9ka\u0159em.<\/div>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\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<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\/cozartan-h\/\">Cozartan-H<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/simlo-5\/\">Simlo 5<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/dilzem-cd\/\">Dilzem CD<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lipvas\/\">Thyronorm<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/salazar\/\">Salazar<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Topicon je topiram\u00e1t 50\/100 mg peror\u00e1ln\u00ed tablety od spole\u010dnosti Intas \u2014 prvn\u00ed volba schv\u00e1len\u00e1 FDA pro prevenci epizodick\u00e9 a chronick\u00e9 migr\u00e9ny (c\u00edlov\u00e9 d\u00e1vkov\u00e1n\u00ed 100 mg\/den). Titrujte od 25 mg na noc s t\u00fddenn\u00edm navy\u0161ov\u00e1n\u00edm. U respondent\u016f sni\u017euje po\u010det migren\u00f3zn\u00edch dn\u016f m\u011bs\u00ed\u010dn\u011b p\u0159ibli\u017en\u011b o 50 %. Kl\u00ed\u010dov\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky: parestezie, kognitivn\u00ed efekt \u201chled\u00e1n\u00ed slov\u201d, \u00fabytek hmotnosti, ledvinov\u00e9 kameny, riziko roz\u0161t\u011bpu patra v prvn\u00edm trimestru t\u011bhotenstv\u00ed.<\/p>","protected":false},"featured_media":61176,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3553,3141,3223,3342,3554],"product_tag":[4994,3467],"class_list":{"0":"post-61175","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-migraine","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_cat-general-health","10":"product_cat-migraine-treatment","11":"product_tag-topicon","12":"product_tag-topiramate","14":"first","15":"instock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/61175","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=61175"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/61176"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=61175"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=61175"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=61175"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=61175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}