{"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\/nl\/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;\">&#9889; Quick Answer &mdash; What is Topicon?<\/h3>\n<p style=\"margin:0;\"><strong>Topicon<\/strong> bevat <strong>topiramate 50 mg \/ 100 mg<\/strong> tablets from Intas Pharmaceuticals &mdash; a sulphamate-substituted monosaccharide anticonvulsant widely used as a <strong>first-line preventive medication for migraine<\/strong> in adults. Also licensed for focal and generalised epilepsy; used off-label for essential tremor, binge-eating disorder, and alcohol use disorder. Typical migraine-prevention dose: <strong>start 25 mg nightly for 1 week, then titrate by 25 mg per week to a target of 100 mg\/day in two divided doses<\/strong> (range 50-200 mg\/day). Full effect at 8-12 weeks. Reduces migraine frequency by ~50% in about half of treated patients (PROMPT, MIGR-001, MIGR-002 trials). Key side effects: <strong>paraesthesia (pins and needles) in 50%<\/strong>, cognitive dulling \/ word-finding difficulty (&#8220;topa-max&#8221; effect), weight loss (often welcomed), metabolic acidosis, kidney stones, and &mdash; important for women &mdash; <strong>cleft lip\/palate risk in first-trimester pregnancy and reduced efficacy of combined oral contraceptives at doses &gt;200 mg\/day<\/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>Wat u krijgt bij MedsBase:<\/strong> WHO-GMP gecertificeerde fabrikant \u00b7 Discrete verpakking \u00b7 Wereldwijde verzending \u00b7 1.400+ geverifieerde <a href=\"https:\/\/medsbase.com\/nl\/reviews\/\">klantbeoordelingen<\/a>\n<\/div>\n<h2 class=\"wp-block-heading\">What Is Topicon?<\/h2>\n<p>Topicon is an oral tablet of <strong>topiramate 50 mg \/ 100 mg<\/strong> from Intas Pharmaceuticals, supplied in 30-180 tablet packs. Topiramate is a sulphamate-substituted monosaccharide originally developed and marketed by Johnson &amp; Johnson as <strong>Topamax<\/strong>; it remains one of the two FDA-approved oral drugs for migraine prevention in adults (alongside propranolol, divalproex, timolol).<\/p>\n<h2 class=\"wp-block-heading\">How Topiramate Prevents Migraine<\/h2>\n<p>The exact mechanism in migraine prophylaxis is multi-modal and not fully defined, but several converging actions explain the effect:<\/p>\n<ul>\n<li><strong>Blokkade van voltage-afhankelijke natriumkanalen<\/strong> &mdash; reduces neuronal hyperexcitability in the trigeminal nucleus caudalis<\/li>\n<li><strong>Potentiation of GABA-A receptor activity<\/strong> &mdash; enhances inhibitory tone<\/li>\n<li><strong>Antagonism of AMPA\/kainate glutamate receptors<\/strong> &mdash; reduces excitatory transmission<\/li>\n<li><strong>Carbonic anhydraseremming<\/strong> (II and IV isoforms) &mdash; responsible for the metabolic acidosis side effect and possibly some antimigraine effect via cortical spreading depression threshold<\/li>\n<li>Suppression of <strong>cortical spreading depression<\/strong> &mdash; the pathophysiological substrate of migraine aura<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Goedgekeurde en evidence-based toepassingen<\/h2>\n<ul>\n<li><strong>Migraine prophylaxis in adults<\/strong> &mdash; FDA-approved 2004 based on MIGR-001 and MIGR-002 trials. ~50% reduction in monthly migraine days in half of treated patients at 100 mg\/day.<\/li>\n<li><strong>Migraine prophylaxis in adolescents 12+<\/strong> &mdash; FDA extension 2014<\/li>\n<li><strong>Chronic migraine<\/strong> &mdash; effective in patients with &ge;15 headache days\/month, 8+ migrainous (Silberstein 2007)<\/li>\n<li><strong>Epilepsie<\/strong> &mdash; focal seizures, generalised tonic-clonic, Lennox-Gastaut syndrome<\/li>\n<li><strong>Obesity (off-label)<\/strong> &mdash; as component of Qsymia (phentermine + topiramate)<\/li>\n<li><strong>Essential tremor, binge-eating disorder, alcohol use disorder, cluster headache prophylaxis<\/strong> &mdash; off-label, evidence variable<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Topicon Dosage for Migraine Prevention<\/h2>\n<p>Topiramate is <strong>titrated slowly<\/strong> to minimise cognitive side effects &mdash; rapid escalation is the single biggest reason patients discontinue.<\/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;\">Week<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">'s Ochtends<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Evening<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Totaal per dag<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Week 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;\">Week 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;\">Week 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;\">\u26a1 Snelle vraag \u2014 Wat is Ecosprin?<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Week 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 (target)<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Streefdosis:<\/strong> 100 mg\/day in two divided doses. If partial response, may escalate to 200 mg\/day, but above 100 mg the side-effect rate rises steeply without proportional benefit.<\/p>\n<p><strong>Evalueer het effect na 8-12 weken.<\/strong> Record monthly migraine days before starting and at week 12; continue if &gt;50% reduction. If no response at 200 mg\/day after 12 weeks, switch agent.<\/p>\n<p><strong>Stopzetting:<\/strong> taper off over 2-4 weeks (reduce by 25 mg every 3-5 days) &mdash; abrupt stop can trigger rebound migraine and, at higher doses, seizure. If you have been on topiramate &ge;1 year, consider a 4-week taper.<\/p>\n<h2 class=\"wp-block-heading\">Bijwerkingen<\/h2>\n<p><strong>Zeer vaak (&gt;10%):<\/strong><\/p>\n<ul>\n<li><strong>Paresthesie<\/strong> (pins and needles, usually hands and feet) &mdash; 50%. Often responds to oral potassium-rich diet or a low dose of potassium citrate.<\/li>\n<li><strong>Cognitieve effecten<\/strong> &mdash; word-finding difficulty, memory lapses, slowed thinking (colloquially &#8220;topa-max&#8221;). Dose-related and often reversible on stopping.<\/li>\n<li><strong>Gewichtsverlies<\/strong> (5-10% body weight common; some consider this a benefit)<\/li>\n<li>Fatigue, drowsiness, dizziness<\/li>\n<li>Altered taste (notably carbonated drinks taste flat)<\/li>\n<li>Nausea, decreased appetite<\/li>\n<\/ul>\n<p><strong>Vaak (1-10%):<\/strong> depression, anxiety, irritability, difficulty concentrating, insomnia, diarrhoea.<\/p>\n<p><strong>Zeldzaam maar belangrijk:<\/strong><\/p>\n<ul>\n<li><strong>Nierstenen<\/strong> (1.5% annual risk; carbonic anhydrase inhibition causes hypocitraturia). Maintain good hydration; potassium citrate supplementation reduces risk.<\/li>\n<li><strong>Metabole acidose<\/strong> with hyperchloraemia &mdash; mild, usually asymptomatic; concern in patients with renal disease<\/li>\n<li><strong>Oligohidrosis<\/strong> (reduced sweating) and hyperthermia &mdash; particularly children in hot climates<\/li>\n<li><strong>Acuut glaucoom met gesloten kamerhoek<\/strong> &mdash; rare but potentially sight-threatening; typically in the first month of therapy. Seek urgent ophthalmology review for eye pain or visual changes.<\/li>\n<li><strong>Stemmings-effecten<\/strong> &mdash; depression and suicidality (class warning for all antiepileptics)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contra-indicaties &amp; Voorzorgsmaatregelen<\/h2>\n<ul>\n<li>Overgevoeligheid voor topiramaat<\/li>\n<li>Ernstige leverfunctiestoornis<\/li>\n<li>Severe renal impairment (eGFR &lt;30) &mdash; dose reduction by 50% needed<\/li>\n<li>Pregnancy &mdash; <strong>topiramate increases the risk of oral clefts (cleft lip\/palate) approximately 3-fold<\/strong> with first-trimester exposure (3-year observational data from the North American AED Pregnancy Registry). Use an effective contraceptive throughout and for 1 month after stopping. If pregnancy occurs, switch preventive immediately.<\/li>\n<li>History of kidney stones (relative contraindication)<\/li>\n<li>Nauwe-kamerhoekglaucoom<\/li>\n<li>Metabolic acidosis \/ sodium bicarbonate &lt;20 mEq\/L<\/li>\n<\/ul>\n<p><strong>Zwangerschap:<\/strong> FDA Pregnancy Category D. If topiramate is the only effective preventive and migraine is severe, weigh risk vs benefit with a neurologist and obstetrician &mdash; rarely continued in pregnancy.<\/p>\n<p><strong>Borstvoeding:<\/strong> topiramate passes into breast milk (milk\/plasma ratio ~0.86). Generally not recommended during breastfeeding.<\/p>\n<p><strong>Contraception:<\/strong> at doses &gt;200 mg\/day, topiramate modestly reduces combined oral contraceptive efficacy (induces CYP3A4). Use a progestin-only pill is NOT an adequate workaround &mdash; use a barrier method or IUD in addition.<\/p>\n<h2 class=\"wp-block-heading\">Geneesmiddelinteracties<\/h2>\n<ul>\n<li><strong>Gecombineerde orale anticonceptiva<\/strong> &mdash; reduced efficacy at &gt;200 mg\/day; use IUD or barrier method<\/li>\n<li><strong>Carbonaatanhydraseremmers<\/strong> (acetazolamide, zonisamide) &mdash; additive acidosis and kidney-stone risk<\/li>\n<li><strong>Alcohol, benzodiazepines, opioids<\/strong> &mdash; additive CNS depression<\/li>\n<li><strong>Other antiepileptics<\/strong> &mdash; phenytoin and carbamazepine reduce topiramate levels; valproate is neutral<\/li>\n<li><strong>Lithium<\/strong> &mdash; topiramate can raise lithium levels<\/li>\n<li><strong>Metformine<\/strong> &mdash; topiramate can alter metformin pharmacokinetics; monitor glucose<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Opslag<\/h2>\n<p>Store below 25&deg;C in original blister. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">Veelgestelde vragen<\/h2>\n<h3 class=\"wp-block-heading\">How long before Topicon starts working for migraine?<\/h3>\n<p>Meaningful reduction in migraine frequency is typically visible from <strong>weeks 4-8<\/strong> as the dose is titrated to target. Full effect is at <strong>8-12 weken<\/strong>. Do not conclude that topiramate has failed until you have been on 100 mg\/day for at least 8 weeks with a migraine diary to compare against baseline.<\/p>\n<h3 class=\"wp-block-heading\">Will Topicon make me lose weight?<\/h3>\n<p>Yes, for about half of patients. Average weight loss in migraine-prevention trials was 4-6 kg over 12 months. Mechanism involves reduced appetite, altered taste of carbonated and fatty foods, and mild metabolic effects. For patients with obesity-associated migraine (a common phenotype), this is welcome; for patients at baseline low weight, it can be a dose-limiting issue.<\/p>\n<h3 class=\"wp-block-heading\">What is the &#8220;topamax&#8221; cognitive effect?<\/h3>\n<p>Dose-related word-finding difficulty, slowed thinking, and mild memory lapses. Usually mild at 50-100 mg\/day; more prominent at 200+ mg. Reversible on dose reduction or stopping. If your work depends on verbal fluency (teaching, law, medicine, software), warn your prescriber and consider an alternative preventive (<a href=\"https:\/\/medsbase.com\/nl\/inderal\/\">propranolol<\/a>, amitriptyline, <a href=\"https:\/\/medsbase.com\/nl\/sibelium\/\">valproaat<\/a>) if cognitive effect interferes with function.<\/p>\n<h3 class=\"wp-block-heading\">Can I drink alcohol on Topicon?<\/h3>\n<p>Moderate use is generally acceptable but alcohol is additive with topiramate&#8217;s sedative and cognitive effects. Alcohol is also a common migraine trigger, so reducing intake often improves migraine frequency independent of topiramate. Avoid alcohol in the first 2-4 weeks of dose titration when cognitive side effects are at their peak.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Topicon in pregnancy?<\/h3>\n<p>No &mdash; topiramate approximately triples the first-trimester risk of cleft lip\/palate (FDA Pregnancy Category D). Women of childbearing potential should use reliable contraception (IUD, barrier; oral contraceptives may be reduced by topiramate at &gt;200 mg\/day). Switch to a safer preventive (<a href=\"https:\/\/medsbase.com\/nl\/inderal\/\">propranolol<\/a> or amitriptyline are preferred in pregnancy) before conception.<\/p>\n<h3 class=\"wp-block-heading\">How do I stop Topicon?<\/h3>\n<p>Taper slowly &mdash; reduce by 25-50 mg every 1-2 weeks over 2-4 weeks total. Abrupt discontinuation can trigger rebound migraine and, at higher doses, seizure (even in patients without epilepsy). Never stop overnight.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Topicon with a triptan?<\/h3>\n<p>Yes &mdash; topiramate is a preventive and triptans are abortive. They work through different mechanisms and are commonly used together: topiramate daily to reduce migraine frequency, a triptan (<a href=\"https:\/\/medsbase.com\/nl\/sumitop\/\">sumatriptan<\/a>, <a href=\"https:\/\/medsbase.com\/nl\/maxtan\/\">rizatriptan<\/a>, <a href=\"https:\/\/medsbase.com\/nl\/zolitas-ods\/\">zolmitriptan<\/a>) as needed for breakthrough attacks.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Topicon online?<\/h3>\n<p>You can buy Topicon (topiramate 50 mg \/ 100 mg, 30-180 tablet packs) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<h2 class=\"wp-block-heading\">Gerelateerde migrainebehandelingen op MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/zolmist-nasal-spray\/\">Zolmist Neusspray \u2014 Zolmitriptan 5 mg (snelle werking)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/zolitas-ods\/\">Zolitas ODS \u2014 Zolmitriptan 2,5\/5 mg orodispergeerbaar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/maxtan\/\">Maxtan \u2014 Rizatriptan 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/rizatop\/\">Rizatop \u2014 Rizatriptan 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/rizact\/\">Rizact \u2014 Rizatriptan (Cipla)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/sumitop\/\">Sumitop \u2014 Sumatriptan 25\/50\/100 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/anti-migraine\/\"><strong>Bekijk alle anti-migrainebehandelingen<\/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 Medisch disclaimer.<\/strong> Deze pagina is alleen voor informatieve doeleinden en vervangt geen medisch advies van een gekwalificeerde zorgprofessional. Raadpleeg altijd uw arts voordat u begint, verandert of stopt met een migrainemedicatie.<\/div>\n<h3>Waarom bestellen bij MedsBase<\/h3>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Elke bestelling is gedekt door onze <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Gerelateerde alternatieven<\/h3>\n<p>Andere producten in <strong>Chronische aandoeningen<\/strong> die klanten ook bekijken:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/cozartan-h\/\">Cozartan-H<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/simlo-5\/\">Simlo 5<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/dilzem-cd\/\">Dilzem CD<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/lipvas\/\">Lipvas<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/salazar\/\">Salazar<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>Topicon is topiramate 50 \/ 100 mg oral tablets from Intas \u2014 a first-line FDA-approved preventive for episodic and chronic migraine (target dose 100 mg\/day). Titrate from 25 mg nightly upwards weekly. Reduces monthly migraine days by ~50% in responders. Key side effects: paraesthesia, cognitive &#8220;word-finding&#8221; effect, weight loss, kidney stones, oral cleft risk in first trimester pregnancy.<\/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\/nl\/wp-json\/wp\/v2\/product\/61175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/comments?post=61175"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media\/61176"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media?parent=61175"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_brand?post=61175"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_cat?post=61175"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_tag?post=61175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}