Topiramate Normon 25 mg film-coated tablets EFG

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Topiramate Normon 25 mg film-coated tablets EFG

This medicinal product is subject to additional monitoring, which will allow rapid identification of new safety information. You can help by reporting any adverse reactions you may experience. Section 4 at the end includes information on how to report these adverse reactions.

Read this entire leaflet carefully before you start taking this medicine, because it contains important information for you.

• Keep this leaflet as you may need to read it again.
• If you have any questions, consult your doctor or pharmacist.
• This medicine has been prescribed for you only, and you must not give it to other people, even if they have the same symptoms as you, because it may harm them.
• If you experience any adverse reactions, consult your doctor or pharmacist, even if they are adverse reactions not listed in this leaflet. See section 4.

Leaflet contents:

1. What Topiramate Normon is and what it is used for
2. What you need to know before taking Topiramate Normon
3. How to take Topiramate Normon
4. Possible adverse effects
5. How to store Topiramate Normon
6. Contents of the pack and other information

1. What Topiramate Normon is and what it is used for

Topiramate Normon belongs to a group of medicines called "antiepileptic drugs". It is used for:

• treating seizures in adults and children over 6 years of age, used alone
• treating seizures in adults and children over 2 years of age, used in combination with other medicines
• preventing migraine in adults

2. What you need to know before taking Topiramato Normon

Do not take Topiramato Normon

• if you are allergic to topiramate or to any of the other components of this medicine (listed in section 6).

Migraine prevention

• Do not take Topiramato Normon if you are pregnant.
• If you are a woman of childbearing potential, you must not take Topiramato Normon unless you are using a highly effective method of contraception throughout your treatment. See below under “Pregnancy, breastfeeding and fertility – Important advice for women”.

Epilepsy treatment

• Do not use Topiramato Normon if you are pregnant, unless no other treatment provides sufficient seizure control.
• If you are a woman of childbearing potential, you must not take Topiramato Normon unless you are using a highly effective method of contraception during treatment. The only exception is if Topiramato Normon is the only treatment providing sufficient seizure control and you plan to become pregnant. You must consult your doctor to ensure you have received information about the risks of taking Topiramato Normon during pregnancy and the risks of seizures during pregnancy. See below under “Pregnancy, breastfeeding and fertility – Important advice for women”.

Make sure to read the patient guide you will receive from your doctor.

A patient card is provided with the Topiramato Normon packaging to remind you of the risks during pregnancy.

If you are unsure whether any of the above applies to you, consult your doctor or pharmacist before using Topiramato Normon.

Warnings and precautions

Consult your doctor before starting Topiramato Normon if you:

• have kidney problems, especially kidney stones, or are undergoing dialysis
• have a history of blood or body fluid disorders (metabolic acidosis)
• have liver problems
• have eye problems, especially glaucoma
• have growth problems
• are on a high-fat diet (ketogenic diet)
• are a woman who could become pregnant. Topiramato Normon may harm an unborn baby when taken during pregnancy. Highly effective contraceptive methods must be used during treatment and for at least 4 weeks after the last dose of Topiramato Normon. See section “Pregnancy and breastfeeding” for more information.
• are pregnant. Topiramato Normon may harm an unborn baby when taken during pregnancy.

If you are unsure whether the above applies to you, consult your doctor before using Topiramato Normon.

If you have epilepsy, it is important not to stop taking your medication without first consulting your doctor.

It is important not to stop taking your medication without first consulting your doctor.

You should consult your doctor before taking any other medicine containing topiramate that may be prescribed as an alternative to Topiramato Normon.

You may lose weight while taking Topiramato Normon, so your weight should be monitored regularly during treatment. If you lose too much weight, or if a child taking this medicine does not gain sufficient weight, consult your doctor.

A small number of people treated with antiepileptic medicines such as Topiramato Normon have had thoughts of harming themselves or committing suicide. If you experience such thoughts at any time, contact your doctor immediately.

Topiramato Normon may cause serious skin reactions. Contact your doctor immediately if you develop a rash and/or blisters (see also section 4 “Possible side effects”).

Topiramato Normon may rarely cause high levels of ammonia in the blood (seen in blood tests), which may lead to changes in brain function, especially if you are also taking a medicine called valproic acid or sodium valproate. Since this may be a serious condition, speak to your doctor immediately if you experience any of the following symptoms (see also section 4 “Possible side effects”):

• difficulty thinking, remembering information, or solving problems
• reduced alertness or consciousness
• feeling drowsy with low energy

The risk of developing these symptoms may increase at higher doses of Topiramato Normon.

Other medicines and Topiramato Normon

Inform your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicines. Topiramato Normon and certain medicines may interact with each other. Sometimes the dose of one or both medicines may need to be adjusted.

In particular, inform your doctor or pharmacist if you are taking:

• other medicines that impair or reduce your mental function, concentration, or muscle coordination (e.g. central nervous system depressants such as muscle relaxants and sedatives).
• hormonal contraceptives. Topiramato Normon may reduce the effectiveness of hormonal contraceptives. An additional barrier contraceptive method such as a condom or diaphragm should be used. Consult your doctor about the most appropriate contraceptive method while taking Topiramato Normon.

Tell your doctor if you experience changes in your menstrual bleeding while taking hormonal contraceptives and Topiramato Normon. Irregular bleeding may occur. In this case, continue taking your hormonal contraceptives and inform your doctor.

Keep a list of all the medicines you are taking. Show this list to your doctor and pharmacist before starting any new medicine.

Other medicines you should discuss with your doctor or pharmacist include other antiepileptic medicines, risperidone, lithium, hydrochlorothiazide, metformin, pioglitazone, gliburide, amitriptyline, propranolol, diltiazem, venlafaxine, flunarizine, St. John’s wort (Hypericum perforatum) (a herbal preparation used to treat depression), and warfarin used to prevent blood clotting.

If you are unsure whether any of the above applies to you, consult your doctor or pharmacist before taking Topiramato Normon.

Use of Topiramato Normon with food and drinks

You may take Topiramato Normon with or without food. Drink plenty of fluids throughout the day to help prevent kidney stone formation while taking Topiramato Normon. You should avoid alcohol while taking Topiramato Normon.

Pregnancy and breastfeeding

Important advice for women of childbearing potential:

Topiramato Normon may harm an unborn baby. If you are a woman of childbearing potential, consult your doctor about other possible treatments. Visit your doctor to review your treatment and discuss risks at least once a year.

Migraine prevention

• For migraine, do not take Topiramato Normon if you are pregnant.
• For migraine, do not use Topiramato Normon if you are a woman of childbearing potential unless you are using a highly effective method of contraception.
• Before starting treatment with Topiramato Normon, a pregnancy test must be performed in women of childbearing potential.

Epilepsy treatment

• For epilepsy, do not take Topiramato Normon if you are pregnant, unless no other treatment provides sufficient seizure control.
• For epilepsy, do not use Topiramato Normon if you are a woman of childbearing potential unless you are using a highly effective method of contraception. The only exception is if Topiramato Normon is the only treatment providing sufficient seizure control and you plan to become pregnant. You must consult your doctor to ensure you have received information about the risks of taking Topiramato Normon during pregnancy and the risks of seizures during pregnancy, which may endanger you or your unborn baby.
• Before starting treatment with Topiramato Normon, a pregnancy test must be performed in women of childbearing potential.

Risks of taking topiramate during pregnancy (regardless of the condition being treated):

There is a risk of harm to the unborn baby if Topiramato Normon is used during pregnancy.

• If you take Topiramato Normon during pregnancy, your baby will have a higher chance of being born with congenital malformations. In women taking topiramate, about 4 to 9 out of every 100 babies will have congenital malformations. This compares with 1–3 out of every 100 babies born to women who do not have epilepsy and are not taking antiepileptic medication. In particular, cleft lip (a split in the upper lip) and cleft palate (a split in the roof of the mouth) have been observed. Male newborns may also have a penile malformation (hypospadias). These defects may develop early in pregnancy, even before you know you are pregnant.
• If you take Topiramato Normon during pregnancy, your child may have a 2 to 3 times higher risk of developing autism spectrum disorders, intellectual disabilities, or attention deficit hyperactivity disorder (ADHD) compared to children born to women with epilepsy who are not taking antiepileptic medication.
• If you take Topiramato Normon during pregnancy, your child may be smaller and weigh less than expected at birth. In one study, 18% of babies born to mothers taking topiramate during pregnancy were smaller and weighed less than expected, compared to 5% of babies born to mothers without epilepsy who were not taking antiepileptic medication.
• Consult your doctor if you have questions about these risks during pregnancy.
• There may be other medicines available to treat your condition with a lower risk of congenital malformations.

Need for contraception in women of childbearing potential:

• If you are a woman of childbearing potential, consult your doctor about other possible treatments instead of Topiramato Normon. If the decision is made to use Topiramato Normon, highly effective contraceptive methods must be used during treatment and for at least 4 weeks after the last dose of Topiramato Normon.
• A highly effective contraceptive method (such as an intrauterine device) or two complementary contraceptive methods (such as a contraceptive pill together with a barrier method such as a condom or diaphragm) should be used. Consult your doctor about the most appropriate contraceptive methods for you.
• If you are taking hormonal contraceptives, there is a possibility of reduced effectiveness due to topiramate. Therefore, an additional barrier contraceptive method (such as a condom or diaphragm) should be used.
• Inform your doctor if you experience irregular menstrual bleeding.

Use of Topiramato Normon in girls:

If you are the parent or caregiver of a girl being treated with Topiramato Normon, consult your doctor immediately once she experiences her first menstrual period (menarche). The doctor will inform you about the risks to an unborn baby due to exposure to topiramate during pregnancy and the need to use highly effective contraceptive methods.

If you plan to become pregnant while taking Topiramato Normon:

• Schedule an appointment with your doctor.
• Do not stop using your contraceptive method until you have discussed this with your doctor.
• If you take Topiramato Normon for epilepsy, do not stop taking it without first discussing this with your doctor, as your condition could worsen.
• Your doctor will reassess your treatment and evaluate alternative treatment options. The doctor will advise you about the risks of Topiramato Normon during pregnancy. The doctor may also refer you to another specialist.

If you become pregnant or think you may be pregnant while taking Topiramato Normon:

• Schedule an urgent appointment with your doctor.
• If you are taking Topiramato Normon to prevent migraines, stop taking the medicine immediately and consult your doctor to evaluate whether you need an alternative treatment.
• If you are taking Topiramato Normon for epilepsy, do not stop taking this medicine until you have discussed this with your doctor, as your condition could worsen. Worsening epilepsy may endanger you or your unborn baby.
• Your doctor will reassess your treatment and evaluate alternative treatment options. The doctor will advise you about the risks of Topiramato Normon during pregnancy. The doctor may also refer you to another specialist.
• If Topiramato Normon is used during pregnancy, you will be closely monitored to check your baby’s development.

Make sure to read the patient guide you will receive from your doctor. A patient card is provided with the Topiramato Normon packaging to remind you of the risks of topiramate during pregnancy.

Driving and using machines

Dizziness, fatigue, and visual disturbances may occur during treatment with Topiramato Normon. Do not drive or operate tools or machinery without first talking to your doctor.

Topiramato Normon contains lactose

If your doctor has informed you that you have an intolerance to certain sugars, consult him before taking this medicine.

3. How to take Topiramate Normon

Follow exactly the instructions for taking this medicine as given by your doctor or pharmacist. If you are unsure, please consult your doctor or pharmacist again.

• Your doctor will usually start you on a low dose of topiramate and slowly increase your dose until the best dose for you is reached.

• Topiramate tablets should be swallowed whole. Avoid chewing the tablets, as they may leave a bitter taste.

• You may take topiramate before, during, or after a meal. Drink plenty of fluids throughout the day to help prevent kidney stone formation while taking topiramate.

Girls and women of childbearing potential:

Treatment with topiramate should be initiated and continued under the supervision of a doctor experienced in the treatment of epilepsy or migraine. Visit your doctor to review your treatment at least once a year.

If you take more Topiramate Normon than you should:

• Contact your doctor immediately. Take the medicine with you.

• You may feel drowsy, tired, or less alert; experience lack of coordination; have difficulty speaking or concentrating; experience double or blurred vision; feel dizzy due to low blood pressure; feel depressed or agitated; or have abdominal pain or seizures (attacks).

You may experience an overdose if you are taking another medicine together with topiramate.

In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicology Information Service at telephone number 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to take Topiramate Normon

• If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Consult your doctor if you forget two or more doses.
• Do not take a double dose (two doses at the same time) to make up for a missed dose.

If you stop taking Topiramate Normon

Do not stop treatment without first consulting your doctor. Your symptoms may return. If your doctor decides you should stop taking this medicine, your dose will be gradually reduced over several days.

If you have any further questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, Topiramate Normon can have adverse effects, although not everyone experiences them.

Consult your doctor or seek immediate medical attention if you experience any of the following adverse effects:

Very common (may affect more than 1 in 10 people)

• Depression (new or worsened)

Common (may affect up to 1 in 10 people)

• Seizures (attacks)
• Anxiety, irritability, mood changes, confusion, disorientation
• Difficulty concentrating, slowed thinking, memory loss, memory problems (onset, sudden change, or increased severity)
• Kidney stones, frequent or painful urination

Uncommon (may affect up to 1 in 100 people)

• Increased blood acid levels (which may cause breathing problems including shortness of breath, loss of appetite, nausea, vomiting, excessive tiredness, and rapid or irregular heartbeat)
• Reduced or absent sweating (especially in young children exposed to high temperatures)
• Thoughts of self-harm, attempting to cause serious harm to oneself
• Loss of part of the visual field

Rare (may affect up to 1 in 1,000 people)

• Glaucoma – blockage of fluid in the eye causing increased eye pressure, eye pain, or vision loss
• Difficulty thinking, remembering information, or solving problems, reduced alertness or consciousness, feeling of numbness with low energy – these symptoms may indicate high levels of ammonia in the blood (hyperammonemia), which can lead to changes in brain function (hyperammonemic encephalopathy)
• Severe skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, which may appear as skin rashes with or without blisters. Skin irritation, ulcers or inflammation in the mouth, throat, nose, eyes, or around the genitals. Skin rashes may progress to widespread skin damage (detachment of the epidermis and superficial mucous membranes), potentially life-threatening.

Not known (cannot be estimated from available data):

• Inflammation of the eyes (uveitis) with symptoms such as eye redness and pain, light sensitivity, tearing, seeing small spots, or blurred vision

Other adverse effects include the following. If they are severe, please consult your doctor or pharmacist:

Very common (may affect more than 1 in 10 people)

• Nasal congestion, runny nose, or sore throat
• Tingling, pain, and/or numbness in various parts of the body
• Drowsiness, fatigue
• Dizziness
• Nausea, diarrhea
• Weight loss

Common (may affect up to 1 in 10 people)

• Anemia (low blood count)
• Allergic reaction (such as skin rash, redness, itching, facial swelling, hives)
• Loss of appetite, decreased appetite
• Aggression, agitation, anger, abnormal behavior
• Difficulty falling or staying asleep
• Problems with speech or speech disorders, poor pronunciation
• Clumsiness or lack of coordination, feeling of unsteadiness when walking
• Reduced ability to perform routine tasks
• Decreased, lost, or absent sense of taste
• Tremors or involuntary shaking; rapid, uncontrollable eye movements
• Vision disturbances, such as double vision, blurred vision, reduced vision, difficulty focusing
• Sensation of spinning (dizziness), ringing in the ears, ear pain
• Shortness of breath
• Cough
• Nosebleeds
• Fever, general malaise, weakness
• Vomiting, constipation, abdominal pain or discomfort, indigestion, stomach or intestinal infection
• Dry mouth
• Hair loss
• Itching
• Joint pain or swelling, muscle spasms or twitches, muscle pain or weakness, chest pain
• Weight gain

Uncommon (may affect up to 1 in 100 people)

• Decreased platelets (blood cells that help prevent bleeding), decreased white blood cells that help protect against infections, decreased blood potassium levels
• Increased liver enzymes, increased eosinophils (a type of white blood cell) in blood
• Swelling of lymph nodes in the neck, armpit, or groin
• Increased appetite
• Elevated mood
• Hearing, seeing, or feeling things that are not there, severe mental disorder (psychosis)
• Lack of emotional expression and/or feeling, unusual distrust, panic attack
• Problems with reading, speech disorder, difficulty writing by hand
• Restlessness, hyperactivity
• Slowed thinking, reduced level of wakefulness or alertness
• Slowed or reduced body movements, abnormal or repetitive involuntary muscle movements
• Fainting
• Abnormal sense of touch; altered touch sensation
• Impaired, distorted, or absent sense of smell
• Unusual feeling or sensation that may precede a migraine or certain types of seizures
• Dry eyes, light sensitivity, eyelid twitching, watery eyes
• Hearing loss, decreased hearing, hearing loss in one ear
• Slow or irregular heartbeat, awareness of heartbeat in the chest
• Decreased blood pressure, drop in blood pressure upon standing (as a result, some people taking Topamax may faint, feel dizzy, or lose consciousness when standing up or sitting up suddenly)
• Flushing or feeling of warmth
• Pancreatitis (inflammation of the pancreas)
• Excess gas or flatulence, stomach acid, feeling of fullness or bloating
• Bleeding gums, increased saliva, drooling, bad breath
• Excessive fluid intake, thirst
• Skin discoloration
• Muscle stiffness, side pain
• Blood in urine, incontinence (lack of control) when urinating, urgency to urinate, side or kidney pain
• Difficulty achieving or maintaining an erection, sexual dysfunction
• Flu-like symptoms
• Cold hands and feet
• Feeling of drunkenness
• Learning difficulties

Rare (may affect up to 1 in 1,000 people)

• Abnormally elevated mood
• Loss of consciousness
• Blindness in one eye, temporary blindness, night blindness
• Lazy eye
• Swelling of the eyes and around the eyes
• Numbness, tingling, and color change (white, blue then red) in fingers and toes when exposed to cold
• Liver inflammation, liver failure
• Unusual skin odor
• Discomfort in arms and legs
• Kidney impairment

Not known (cannot be estimated from available data)

• Maculopathy is a disease of the macula, a small area in the retina where vision is sharpest. Consult your doctor if you notice any change or decrease in your vision.

Other adverse effects in children

In general, adverse effects observed in children are similar to those seen in adults, but the following adverse effects may be more common in children than in adults:

• Difficulty concentrating
• Increased blood acid levels
• Thoughts of self-harm
• Tiredness
• Decreased or increased appetite
• Aggression, abnormal behavior
• Difficulty falling or staying asleep
• Feeling of unsteadiness when walking
• General malaise
• Decreased blood potassium levels
• Lack of emotional expression and/or feeling
• Watery eyes
• Slow or irregular heartbeat

Other adverse effects that may occur in children include:

Common (may affect up to 1 in 10 people)

• Sensation of spinning (dizziness)
• Vomiting
• Fever

Uncommon (may affect up to 1 in 100 people)

• Increased eosinophils (a type of white blood cell) in blood
• Hyperactivity
• Feeling of warmth
• Learning difficulties

Reporting of adverse effects

If you experience any adverse effects, consult your doctor, pharmacist, or nurse, even if they are possible adverse effects not listed in this leaflet. You may also report them directly via the Spanish Pharmacovigilance System for Human Medicines: https://www.notificaram.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Topiramate Normon

Keep this medicine out of sight and reach of children.

Do not store above 30°C.

Store in the original packaging to protect from moisture.

Do not use Topiramate Normon after the expiry date which is stated on the packaging after EXP. The expiry date refers to the last day of the month indicated.

Medicines must not be disposed of via wastewater or household waste. Dispose of empty containers and unused medicines at the SIGRE point located at your pharmacy. If you have any doubts, ask your pharmacist how to properly dispose of containers and unused medicines. This will help protect the environment.

6. Contents of the pack and other information

Composition of Topiramate Normon

• The active substance is topiramate.

• Topiramate Normon 25 mg: each tablet contains 25 mg of topiramate.

• The other components (excipients) are:

  • Core: lactose, microcrystalline cellulose, hydroxypropylcellulose, magnesium stearate and colloidal silicon dioxide.
  • Coating: hypromellose, titanium dioxide (E-171) and macrogol 6000.

Appearance of Topiramate Normon and contents of the pack

Topiramate Normon 25 mg is available in packs containing 28 and 60 film-coated tablets, white or almost white, round, biconvex and printed.

Marketing Authorization Holder and Manufacturer

LABORATORIOS NORMON, S.A.

Ronda de Valdecarrizo, 6 – 28760 – Tres Cantos – Madrid, Spain

The most recent revision of this leaflet: June 2024

Detailed information about this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) www.aemps.gob.es

The most recently approved information; educational material (patient guide) about this medicine is available by scanning the following QR code with a smartphone. The same information is also available at the following web address (URL): https://cima.aemps.es/cima/DocsPub/16/3252.