Oritop

Package Leaflet: Information for the User

Oritop 25 mg, 50 mg, 100 mg, Coated Tablets

Topiramate
This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See section 4 for how to report side effects.

You should carefully read the leaflet before taking the medicine, as it contains important information for the patient.

• You should keep this leaflet, so you can read it again if you need to.
• If you have any doubts, you should consult a doctor or pharmacist.
• This medicine has been prescribed specifically for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If you experience any side effects, including those not listed in this leaflet, you should tell your doctor or pharmacist. See section 4.

Table of Contents of the Leaflet:

• 1. What Oritop is and what it is used for
• 2. Important information before taking Oritop
• 3. How to take Oritop
• 4. Possible side effects
• 5. How to store Oritop
• 6. Contents of the pack and other information

1. What Oritop is and what it is used for

Oritop belongs to a group of medicines called antiepileptic drugs.
It is used:

• as a single drug in the treatment of seizures in adults and children over 6 years of age
• in combination with other medicines for the treatment of seizures in adults and children over 2 years of age
• to prevent migraine headaches in adults.

2. Important information before taking Oritop

When not to take Oritop

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

Migraine Prevention

• Oritop should not be taken during pregnancy.
• If you are of childbearing age, you should not take Oritop without using highly effective contraception during treatment. See below in the section "Pregnancy, breastfeeding and fertility - important advice for women".

Seizure Treatment

• Oritop should not be taken if you are pregnant, unless no other treatment method provides sufficient control of seizures.
• Oritop should not be taken if you are of childbearing age, unless you are using highly effective contraception during treatment. The only exception is when Oritop is the only medicine that provides sufficient control of seizures, and you plan to become pregnant. You should discuss this with your doctor to ensure you have been informed about the risk of taking Oritop during pregnancy and the risk of seizures during pregnancy, which may put you or your unborn child at risk.
• Before starting Oritop, you should have a pregnancy test if you are of childbearing age.

You must read the patient instruction provided by your doctor or scan the QR code (see section 6 "Other sources of information").
A patient card is included with the packaging of Oritop, which reminds you of the risk associated with pregnancy.
If you are unsure whether any of the above applies to you, you should consult your doctor or pharmacist before taking Oritop.

Warnings and precautions

Before starting Oritop, you should discuss with your doctor if you have:

• kidney disease, especially kidney stones or dialysis
• blood and body fluid disorders (metabolic acidosis)
• liver disease
• eye diseases, especially glaucoma
• growth disorders
• you are on a high-fat diet (ketogenic diet)
• you are a woman of childbearing age. Oritop taken during pregnancy may harm your unborn child. During treatment and for at least 4 weeks after the last dose of Oritop, you should use highly effective contraception. Further information can be found in the section "Pregnancy and breastfeeding".
• you are pregnant. Oritop taken during pregnancy may harm your unborn child.

If you are unsure whether any of the above applies to you, you should consult your doctor before taking Oritop.
If you have epilepsy, it is important not to stop taking your medicine without first consulting your doctor.
You should consult your doctor before taking any medicine containing topiramate, which has been prescribed to you as a substitute for Oritop.
During Oritop treatment, you may lose weight, so you should regularly check your body weight during treatment with this medicine. If you lose too much weight or if your child taking this medicine does not gain enough weight, you should consult your doctor.

A small number of people taking antiepileptic medicines, such as Oritop, have had thoughts of harming themselves or committing suicide. If you ever have these thoughts, you should contact your doctor immediately.
Oritop may cause severe skin reactions; if you experience a rash and/or blisters on the skin, you should immediately inform your doctor (see also section 4 "Possible side effects").
Oritop may rarely cause an increase in blood ammonia levels (detected in blood tests), which can lead to changes in brain function, especially if you are also taking a medicine containing valproic acid or sodium valproate. As this can be a serious condition, you should immediately tell your doctor if you experience any of the following side effects:

• difficulty thinking, remembering, or solving problems
• decreased alertness or awareness
• feeling extremely sleepy with a lack of energy.

The risk of these symptoms may increase with high doses of Oritop.
Warning! The tablet container contains a desiccant. Do not swallow.

Oritop and other medicines

You should tell your doctor or pharmacist about all medicines you are taking now or have recently taken, as well as any medicines you plan to take. Oritop may interact with other medicines. In some cases, your doctor may need to adjust the dose of the medicines you are taking or adjust the dose of Oritop.
In particular, you should inform your doctor or pharmacist if you are taking:

• other medicines that can harm or decrease thinking, concentration, or muscle coordination (such as central nervous system depressants, such as muscle relaxants and sedatives)
• hormonal contraceptives. Oritop may decrease the effectiveness of hormonal contraceptives. You should use an additional barrier method of contraception, such as a condom or diaphragm/cervical cap. You should discuss with your doctor the best method of contraception to use during Oritop treatment.

You should inform your doctor if you experience any changes in your menstrual bleeding while taking hormonal contraceptives with Oritop. You may experience irregular menstrual bleeding. In this case, you should continue taking your hormonal contraceptives and inform your doctor.
You should keep a list of all the medicines you are taking. When starting a new medicine, you should show this list to your doctor and pharmacist.
Taking other medicines, such as antiepileptic medicines, risperidone, lithium, hydrochlorothiazide, metformin, pioglitazone, glibenclamide, amitriptyline, propranolol, diltiazem, venlafaxine, flunarizine, St. John's Wort (Hypericum perforatum) (a herbal preparation used to treat depression), warfarin, used to thin the blood, should be discussed with your doctor or pharmacist.
If you are unsure whether the above text applies to you, you should consult your doctor or pharmacist before taking Oritop.

Oritop with food, drink, and alcohol

Oritop can be taken with or without food. You should drink plenty of fluids during the day to prevent the formation of kidney stones while taking Oritop. During Oritop treatment, you should avoid consuming alcohol.

Pregnancy and breastfeeding

Important advice for women of childbearing age

Oritop may harm your unborn child. Women of childbearing age should discuss with their doctor the possibility of using other treatment methods. At least once a year, you should visit your doctor to monitor your treatment and discuss the risks.
Migraine prevention:

• In the case of migraines, Oritop should not be taken during pregnancy.
• In the case of migraines, Oritop should not be taken if you are of childbearing age unless you are using highly effective contraception.
• Before starting Oritop, you should have a pregnancy test if you are of childbearing age.

Seizure treatment:

• In the case of seizures, Oritop should not be taken if you are pregnant, unless no other treatment method provides sufficient control of seizures.
• In the case of seizures, Oritop should not be taken if you are of childbearing age unless you are using highly effective contraception. The only exception is when Oritop is the only medicine that provides sufficient control of seizures, and you plan to become pregnant. You should discuss this with your doctor to ensure you have been informed about the risk of taking Oritop during pregnancy and the risk of seizures during pregnancy, which may put you or your unborn child at risk.
• Before starting Oritop, you should have a pregnancy test if you are of childbearing age.

Risk of taking topiramate during pregnancy (regardless of the disease being treated):
If Oritop is taken during pregnancy, there is a risk of fetal harm.

• Taking Oritop during pregnancy increases the risk of birth defects in the child. In women taking topiramate, birth defects occur in about 4-9 out of 100 children. For comparison, this figure is 1-3 out of 100 children born to women who do not have epilepsy and do not take antiepileptic medicines. In particular, cleft lip (cleft lip) and cleft palate (cleft palate) have been observed. In newborn boys, a developmental defect of the penis (hypospadias) may also occur. These defects can develop early in pregnancy, even before you know you are pregnant.
• In the case of taking Oritop during pregnancy, the risk of autism spectrum disorders, intellectual disability, or attention deficit hyperactivity disorder (ADHD) in the child may be 2 to 3 times higher than in children born to women with epilepsy who do not take antiepileptic medicines.
• In the case of taking Oritop during pregnancy, the child may be smaller and have a lower birth weight. In one study, 18% of children whose mothers took topiramate during pregnancy were smaller and weighed less than expected, while in women without epilepsy who did not take antiepileptic medicines, this figure was 5% of newborns.
• If you have any doubts, you should ask your doctor about the risks during pregnancy.
• There may be other medicines used to treat this disease that are associated with a lower risk of birth defects.

Necessity of contraception in women of childbearing age:

• Women of childbearing age should discuss with their doctor the possibility of using other treatment methods instead of Oritop. If you decide to start treatment with Oritop, you should use highly effective contraception during treatment and for at least 4 weeks after the last dose of Oritop.

You should use one highly effective contraceptive method (such as an intrauterine device) or two complementary methods of contraception, such as a contraceptive pill, in combination with a mechanical method of contraception (such as a condom or diaphragm/cervical cap). You should discuss with your doctor which method of contraception will be most suitable for you.

• If you are taking hormonal contraceptives, topiramate may decrease their effectiveness. Therefore, you should use an additional barrier method of contraception (such as a condom or diaphragm/cervical cap).
• If you experience irregular menstrual bleeding, you should inform your doctor.

Use of Oritop in girls:
The parents or guardians of a girl taking Oritop should immediately contact the doctor when the girl experiences her first menstrual period. The doctor will inform them about the risk to the unborn child resulting from exposure to topiramate during pregnancy and the need to use highly effective contraception.
If you want to become pregnant while taking Oritop:

• You should make an appointment with your doctor.
• You should not stop using contraception until you have discussed this with your doctor.
• If you are taking Oritop for epilepsy, you should not stop taking it without consulting your doctor, as your condition may worsen.
• Your doctor will reassess your treatment and alternative treatment options. Your doctor will inform you about the risk of taking Oritop during pregnancy. Your doctor may also refer you to another specialist.

If you become pregnant or think you may be pregnant while taking Oritop:

• You should make an urgent appointment with your doctor.
• In the case of migraine prevention, you should immediately stop taking Oritop and contact your doctor, who will assess whether alternative treatment is necessary.
• If you are taking Oritop for epilepsy, you should not stop taking it without consulting your doctor, as this may worsen your condition. Worsening of epilepsy may put you or your unborn child at risk.
• Your doctor will reassess your treatment and alternative treatment options. Your doctor will inform you about the risk of taking Oritop during pregnancy. Your doctor may also refer you to another specialist.
• If Oritop is taken during pregnancy, you will be closely monitored to check the development of your unborn child.

You must read the patient instruction provided by your doctor. A patient guide can also be obtained by scanning the QR code (see section 6 "Other sources of information").
A patient card is included with the packaging of Oritop, which reminds you of the risk associated with pregnancy.
Breastfeeding
The active substance of Oritop, topiramate, passes into breast milk. In children breastfed by mothers taking this medicine, side effects such as diarrhea, drowsiness, irritability, and low weight gain have been reported. Therefore, your doctor will discuss with you whether to stop breastfeeding or stop taking Oritop. Your doctor will consider the importance of the medicine for you and the risk for your child.
Mothers taking Oritop during breastfeeding should immediately inform their doctor if they notice any changes in their child's behavior.

Driving and using machines

While taking Oritop, you may experience dizziness, fatigue, and vision problems.
Before consulting your doctor, you should not drive, operate any machinery, or use tools.

Oritop contains lactose

Oritop coated tablets contain 20.1 mg (25 mg tablets), 40.2 mg (50 mg tablets), or 80.4 mg (100 mg tablets) of lactose (in the form of lactose monohydrate). If you have been diagnosed with intolerance to some sugars, you should contact your doctor before taking this medicine.

Other excipients

The medicine contains less than 1 mmol (23 mg) of sodium per tablet, which means the medicine is considered "sodium-free".

3. How to take Oritop

This medicine should always be taken exactly as directed by your doctor or pharmacist. If you are unsure, you should consult your doctor or pharmacist.

• Your doctor will usually start treatment with a low dose of Oritop and gradually increase it until the optimal dose for you is determined.
• Oritop tablets should be swallowed whole. It is not recommended to chew the tablets, as they may leave a bitter taste.
• Oritop can be taken before, during, or after meals. While taking Oritop, you should drink plenty of fluids to avoid the formation of kidney stones.

Girls and women of childbearing age:
Treatment with Oritop should be started and supervised by a doctor experienced in the treatment of epilepsy or migraines. At least once a year, you should visit your doctor to monitor your treatment.

Overdose of Oritop

• You should immediately contact your doctor. You should take the packaging of the medicine with you.
• You may feel drowsy, tired, or weak; lack coordination; have difficulty speaking or concentrating; have double or blurred vision; may feel dizzy due to low blood pressure; may feel depressed or agitated; may have abdominal pain or seizures.

Overdose can also occur when taking other medicines with Oritop.

Missed dose of Oritop

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

Stopping Oritop treatment

You should not stop treatment unless your doctor advises you to do so. After stopping treatment, the symptoms of the underlying disease may return. If your doctor decides to stop treatment, the dose of Oritop may be gradually decreased over a few days.
If you have any further doubts about taking this medicine, you should consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, Oritop can cause side effects, although not everybody gets them.

You should immediately contact your doctor or seek medical attention if you experience any of the following side effects:

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

• depression (new onset or worsening of existing depression).

Common ( may affect up to 1 in 10 people):

• seizures (seizure attacks)
• anxiety, irritability, mood changes, confusion, disorientation
• concentration disorders, slowed thinking, memory loss, memory disorders (new cases, sudden changes, or increased severity)
• kidney stones, frequent or painful urination.

Uncommon ( may affect up to 1 in 100 people):

• increased blood acid levels (which can cause breathing difficulties, including shortness of breath, loss of appetite, nausea, vomiting, excessive fatigue, and rapid or irregular heartbeat)
• decreased sweating or lack of sweating (especially in young children, if exposed to high temperatures)
• thoughts of self-harm - harming oneself, attempting to cause serious harm to oneself
• partial loss of vision

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

• glaucoma, which is characterized by fluid accumulation in the eye chamber, causing increased pressure in the eyeball, pain, and impaired vision.
• difficulty thinking, remembering, or solving problems, decreased alertness or awareness, feeling extremely sleepy with a lack of energy - may be symptoms of high blood ammonia levels (hyperammonemia), which can lead to changes in brain function (hyperammonemic encephalopathy)
• severe skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis - may appear as a rash with blisters or without. Skin irritation, ulcers, or swelling in the mouth, throat, nose, eyes, and genital areas. Skin rashes can transform into severe, extensive skin damage (exfoliation and erosion of the skin and mucous membranes), which can be life-threatening.

Unknown ( frequency cannot be estimated from the available data):

• eye inflammation (uveitis) with symptoms such as eye redness, pain, sensitivity to light, tearing, or blurred vision.

Other side effects are as follows; if they become severe, you should contact your doctor or pharmacist:

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

• runny nose with accompanying nasal congestion or sore throat
• tingling, pain, and/or numbness in different parts of the body
• drowsiness, fatigue
• dizziness
• nausea, diarrhea
• weight loss.

Common ( may affect up to 1 in 10 people):

• anemia (decreased red blood cell count)
• allergic reactions (such as rash, redness, itching, swelling of the face, hives)
• loss of appetite, decreased appetite
• aggression, agitation, anger, abnormal behavior
• difficulty sleeping or maintaining sleep continuity
• speech difficulties or speech disorders, slurred speech
• ataxia or lack of muscle coordination, feeling unsteady while walking
• decreased ability to perform routine tasks
• taste disorders, loss of taste or decreased sense of taste
• involuntary tremors or seizures, rapid, involuntary eye movements
• vision disorders, such as double vision, blurred vision, decreased vision, decreased visual acuity
• feeling of spinning (dizziness), ringing in the ears, ear pain
• shortness of breath
• cough
• nosebleeds
• fever, malaise, weakness
• vomiting, constipation, abdominal pain or discomfort, indigestion, stomach or intestinal infections
• dry mouth
• hair loss
• itching
• joint pain or swelling, muscle cramps or muscle spasms, muscle pain or weakness, chest pain
• weight gain.

Uncommon ( may affect up to 1 in 100 people):

• decreased platelet count (blood cells that help stop bleeding), decreased white blood cell count (which helps protect against infection), decreased potassium levels in the blood
• increased liver enzyme activity, increased eosinophil count (a type of white blood cell) in the blood
• swollen lymph nodes in the neck, armpits, and groin
• increased appetite
• elevated mood
• hearing, seeing, or feeling things that are not there, severe mental disorders (psychosis)
• lack of emotional expression or emotional response, excessive suspiciousness, panic attacks
• difficulty reading, speech disorders, difficulty with manual writing
• restlessness, hyperactivity
• slowed thinking, decreased mental clarity or alertness
• limited or slow body movements, involuntary abnormal or repetitive movements
• fainting
• impaired sensation, impaired sense of touch
• disorders, distortions, or loss of sense of smell
• unusual sensations or feelings, which may precede a migraine or a certain type of seizure
• dry eyes, eye sensitivity to light, eyelid twitching, tearing
• decreased or complete loss of hearing, hearing loss in one ear
• slow or irregular heartbeat, feeling of heartbeat in the chest
• low blood pressure, low blood pressure when standing up from a sitting or lying position (which may cause some patients taking Oritop to feel weak, dizzy, or faint when standing up quickly)
• hot flashes
• pancreatitis
• excessive gas or bloating, heartburn, feeling of fullness in the abdominal cavity or bloating
• gum bleeding, excessive saliva production, drooling, bad breath
• excessive fluid intake, increased thirst
• skin discoloration
• muscle stiffness, side pain
• blood in the urine, urinary incontinence (loss of bladder control), urgent need to urinate, kidney pain, or side pain
• difficulty achieving or maintaining an erection, sexual disorders
• flu-like symptoms
• cold hands and feet
• feeling of intoxication
• difficulty learning.

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

• suddenly changed mood
• loss of consciousness
• one-sided blindness, transient blindness, night blindness
• amblyopia (lazy eye)
• swelling of the tissues around the eye
• numbness, tingling, and color change (white, blue to red) in the fingers of the hands and feet in response to cold
• hepatitis, liver failure
• unpleasant body odor
• feeling of discomfort in the arms and legs
• kidney disorders.

Unknown ( frequency cannot be estimated from the available data):

• macular degeneration, which is a disease of the macula, a small area of the retina of the eye, the part of the eye responsible for sharp vision. If you notice any changes in your vision or decreased vision, you should contact your doctor.

Children

Side effects in children are similar to those observed in adults, but the following side effects may occur more frequently in children than in adults:

• concentration problems
• increased blood acid levels
• thoughts of self-harm
• feeling of fatigue
• decreased or increased appetite
• aggression, abnormal behavior
• difficulty sleeping or insomnia
• feeling of unsteadiness while walking
• malaise
• decreased potassium levels in the blood
• lack of emotional expression or emotional response
• tearfulness
• slow or irregular heartbeat.

Other side effects that may occur in children include:
Common ( may affect up to 1 in 10 people):

• feeling of spinning (dizziness)
• vomiting
• fever.

Uncommon ( may affect up to 1 in 100 people):

• increased eosinophil count (a type of white blood cell) in the blood
• hyperactivity
• feeling of heat
• difficulty learning.

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, you should tell your doctor or pharmacist. Side effects can be reported directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products:
Jerozolimskie Avenue 181C, 02-222 Warsaw,
phone: 22 49-21-301, fax: 22 49-21-309,
website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Oritop

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the packaging.
The expiry date refers to the last day of the month.
Do not store above 30°C.
Do not use this medicine if you notice any discoloration or other signs of deterioration.
Medicines should not be disposed of via wastewater or household waste. You should ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the pack and other information

What Oritop contains

• The active substance of Oritop is topiramate. Each coated tablet contains 25 mg, 50 mg, or 100 mg of topiramate.
• The other ingredients are: Tablet core:Microcrystalline cellulose, lactose monohydrate, maize starch, sodium carboxymethylcellulose (type A), magnesium stearate. Coating:Hypromellose, titanium dioxide (E171), macrogol 400, polysorbate 80, and additionally yellow iron oxide (E172) in 50 mg and 100 mg tablets.

What Oritop looks like and contents of the pack

Round, biconvex, coated tablets with a marking on one side.
Oritop 25 mg coated tablets: white tablets with a marking "22" on the other side.
Oritop 50 mg coated tablets: light yellow tablets with a marking "33" on the other side.
Oritop 100 mg coated tablets: dark yellow tablets with a beveled edge, with a marking "23" on the other side.
Pack sizes: 60 and 100 coated tablets in HDPE bottles.
Not all pack sizes may be marketed.

Marketing authorization holder

Orion Corporation
Orionintie 1
FI-02200 Espoo
Finland

Manufacturer

Orion Corporation, Orion Pharma
PO Box 65
FI-02101 Espoo
Finland
To obtain more detailed information on this medicine, you should contact the local representative of the marketing authorization holder:
Orion Pharma Poland Sp. z o. o.
kontakt@orionpharma.info.pl

This medicine is authorized in the Member States of the European Economic Area under the following names:

Denmark:
Topiramat Orion 25 mg, 50 mg, 100 mg, 200 mg film-coated tablets
Estonia:
Topiramate Orion 25 mg, 50 mg, 100 mg, 200 mg film-coated tablets
Finland: Topiramat Orion 25 mg, 50 mg, 100 mg, 200 mg tablets, film-coated;
Topiramat Orion 25 mg, 50 mg, 100 mg, 200 mg film-coated tablets
Lithuania:
Topiramat Orion 25 mg, 50 mg, 100 mg, 200 mg film-coated tablets
Poland:
Oritop 25 mg, 50 mg, 100 mg, coated tablets
Sweden:
Topiramat Orion 25 mg, 50 mg, 100 mg, 200 mg film-coated tablets
Date of last revision of the leaflet:08.05.2024

Other sources of information

The latest approved information (patient card and patient guide) about this medicine is available by scanning the following QR code with your smartphone. The same information is also available on the website (URL): qr.orionproductsafety.com/topiramate/pl/
QR code to URL: http:// qr.orionproductsafety.com/topiramate/pl/