目前topiramate只准用於治療成人和兩歲以上兒童的癲癎症以及預防成人的偏頭痛。近期澳洲的一宗個案中, 一名病人獲處方topiramate以協助減輕體重後, 因急性閉角性青光眼而被送進急症室, 這是topiramate已知的嚴重不良反應。基於藥物用於非核准的適應症時, 尚未充份評估其安全性和有效性, 有的甚至風險高於效益, 因此, 建議衛生專業人士應嚴格按照臨床指引治療體重過高和肥胖症病人。
Calamine是由氧化鋅和少量氧化鐵組成的粉末, 外用製劑用於輕微皮膚刺激和其他輕微的皮膚症狀。如在進行X-射線檢查前使用這些產品, 當中的氧化鋅成份可能會產生類似乳房內鈣化的效果, 這是早期乳癌的重要指徴。基於calamine產品可能會影響放射影像的結果, 建議不要在接受X-射線檢查前在皮膚上使用這些產品。
Topiramate: adverse events associated with off-labels indications
Topiramate is only approved for the treatment of epilepsy in adults and children aged two years and over and prevention of migraine headaches in adults.It is reported recently in Australia that a patient who was prescribed topiramate to assist with weight loss presented to the emergency department with acute closed angle glaucoma.This is a serious and known side effect of topiramate therapy.Due to the safety and efficacy have not been fully evaluated in drug’s off-labels indications or the balances were even compromised, we advise health professionals strictly practice with clinical guidelines during treating patients with overweight and obesity.
Calamine: may affect the outcome of the radiograph
Calamine is fine powder of zinc oxide with a small proportion of ferric oxide.Its topical products are used for mild skin irritations and other minor skin conditions.If used on the skin before a X-ray examination, the zinc oxide contained in these products may mimic intramammary calcifications, which can be an important indicator of early breast cancer. It is advised not to apply calamine products onto the skin before an X-ray examination because it may affect the outcome of the radiograph.