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The primary concern with hepatic impairment is a potential change in exposure to a drug that is extensively cleared by hepatic metabolism or biliary excretion via the liver, that could impact on the pharmacodynamic action or lead to adverse effects [19]

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This adjustment period can vary among individuals, with some experiencing quicker relief than others, depending on their overall health and dietary habits

Both neurogenic inflammation and oxidative stress are key factors in migraine development, and topiramates neuroprotective potential through its anti-inflammatory and antioxidative effects is noted