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Quick guide to Topamax

Brand Name(s): Topamax

Generic Name Topiramate

What are topiramate tablets or sprinkle capsules?

TOPIRAMATE (Topamax®) is effective in helping to control seizures (convulsions) in adults or children with various forms of epilepsy. Topiramate may also be prescribed for other conditions, such as prevention of migraine headaches. Generic topiramate tablets or sprinkle-capsules are not yet available.

What should my health care professional know before I take topiramate?

They need to know if you have any of these conditions:

  • cirrhosis of the liver or other liver disease
  • glaucoma
  • kidney stones
  • kidney disease
  • an unusual or allergic reaction to topiramate, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I take this medicine?

Take topiramate tablets and capsules by mouth. Swallow the tablets whole with a drink of water; do not crush or chew. The capsules can be swallowed whole or opened carefully and the contents sprinkled on about on a small amount of soft food, such as applesauce, pudding, ice cream, oatmeal, or yogurt. This mixture must be swallowed immediately; do not chew or store the sprinkles on the food for later use. Be sure to take the entire dose. You may take topiramate with meals. Take your doses at regular intervals. Do not take your medicine more often than directed.

Topiramate should be taken on a daily basis as prescribed by your health care professional for the prevention of migraine headaches. Topiramate should not be used to 'abort' or stop a migraine once it has started.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. Topiramate has been used in children for the treatment of various seizure disorders.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What drug(s) may interact with topiramate?

  • acetazolamide
  • birth control pills or other hormones for birth control, including implants or injections
  • bosentan
  • carbamazepine
  • dichlorphenamide
  • digoxin
  • ethanol
  • medications for pain, sleep, or muscle relaxation
  • methazolamide
  • phenobarbital or primidone
  • phenytoin
  • probenecid
  • valproic acid

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking topiramate?

Side effects that you should report to your prescriber or health care professional as soon as possible:

  • agitation, restlessness, irritability, or other changes in mood
  • decreased sweating and/or rise in body temperature
  • depression, or mood changes
  • difficulty breathing; fast or irregular breathing patterns
  • difficulty speaking
  • difficulty walking or controlling muscle movements
  • eye pain, redness or swelling
  • hearing impairment
  • kidney stones (severe pain in the side or back, or on urination)
  • nose bleeds
  • redness, blistering, peeling or loosening of the skin, including inside the mouth
  • skin rash, itching
  • stomach pain with nausea or vomiting
  • swelling of the face, lips or tongue
  • tingling, pain or numbness in the hands or feet
  • unusual weakness or tiredness
  • vision problems, like blurred vision
  • vomiting
  • yellowing of the skin or eyes

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • back pain, joint aches and pains
  • breast pain
  • diarrhea, or constipation
  • difficulty sleeping
  • dizziness, drowsiness
  • dry mouth
  • headache
  • hot flashes
  • loss of appetite
  • menstrual disorder
  • muscle aches or pains
  • nausea
  • swelling of the gums
  • stomach upset, indigestion
  • stuffy, runny nose
  • sweating
  • tiredness or weakness
  • tremor

What should I watch for while taking topiramate?

Visit your prescriber or health care professional for a regular check on your progress. Do not stop taking topiramate suddenly. This increases the risk of seizures. Wear a Medic Alert bracelet or necklace. Carry an identification card with information about your condition, medications, and prescriber or health care professional.

You should drink plenty of fluids while taking topiramate. If you have had kidney stones in the past, this will help to reduce your chances of forming kidney stones.

If you have stomach pain, with nausea or vomiting and yellowing of your eyes or skin, call your health care provider immediately.

You may get drowsy, dizzy, or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how topiramate affects you. To reduce dizziness, do not sit or stand up quickly, especially if you are an older patient. Alcohol can increase drowsiness and dizziness. Avoid alcoholic drinks.

If you take birth control pills, topiramate may reduce their effectiveness at preventing pregnancy. Notify your prescriber or health care professional if you notice changes in your monthly cycles or bleeding patterns. You may want to discuss birth control options with your health care provider.

If you notice blurred vision, eye pain, or other eye problems, seek medical attention at once for an eye exam.

If you are going to have surgery, tell your prescriber or health care professional that you are taking topiramate.

Where can I keep my medicine?

Keep out of reach of children in a container that small children cannot open.

Store at room temperature between 15 and 30 °C (59 and 86 °F) in a tightly closed container. Protect from moisture. Throw away any unused medicine after the expiration date.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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