Generic Name: Topiramate Brand Name(s): Generics only. No brands available.

Uses

What is topiramate used for?

Topiramate is used alone or with other medications to prevent and control seizures (epilepsy). This medication is also used to prevent migraine headaches and decrease how often you get them. Topiramate will not treat a migraine headache once it occurs. If you get a migraine headache, treat it as directed by your doctor (such as by taking pain medication, lying down in a dark room).

Topiramate is known as an anticonvulsant or antiepileptic drug.

How should I take topiramate?

Take topiramate by mouth with or without food.

Drinking extra fluids while you are taking topiramate is recommended. Doing so may help to prevent kidney stones from forming. Check with your doctor for instructions.

Swallow whole. Do not crush or chew. The tablet may leave a bitter taste.

Do not suddenly stop taking topiramate. Suddenly stopping topiramate may increase the risk of seizures. If you need to stop topiramate, your doctor will gradually lower your dose.

How do I store topiramate?

Topiramate is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store topiramate in the bathroom or the freezer. There may be different brands of topiramate that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush topiramate down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using topiramate?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of topiramate or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using topiramate during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking topiramate. Topiramate is pregnancy risk category D, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from topiramate?

Check with your doctor if any of these most common side effects persist or become bothersome:

  • Constipation
  • Diarrhea
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Flushing
  • Headache
  • Loss of appetite
  • Nausea
  • Nervousness
  • Stomach pain or upset
  • Symptoms of upper respiratory tract infection (e.g., cough, mild sore throat, running or stuffy nose, sneezing)
  • Taste changes
  • Tiredness
  • Trouble sleeping
  • Weakness
  • Weight loss

Seek medical attention right away if any of these severe side effects occur:

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
  • Bone pain
  • Burning, numbness, or tingling
  • Chest pain
  • Confusion
  • Decreased coordination
  • Decreased or painful urination
  • Fever, chills, or persistent cough or sore throat
  • Loss of consciousness
  • Memory problems
  • Menstrual changes
  • Muscle or joint pain, cramps, or weakness
  • New or worsening mental, mood, or behavior changes (e.g., aggressiveness, agitation, anxiety, depression, exaggerated feeling of well-being, hostility, impulsiveness, inability to sit still, irritability, panic attacks, restlessness)
  • Red, swollen, blistered, or peeling skin
  • Ringing in the ears
  • Severe or persistent drowsiness
  • Severe stomach, side, or back pain
  • Significant weight loss
  • Speech problems
  • Stupor
  • Suicidal thoughts or actions
  • Symptoms of bleeding (e.g., throwing up blood or vomit that looks like coffee grounds; coughing up blood; blood in urine; black, red, or tarry stools; bleeding from the gums; unusual vaginal bleeding; bruises without a reason or bruises that get bigger; any bleeding that is severe or that you cannot stop)
  • Tremor
  • Trouble focusing

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with topiramate?

Topiramate may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Anticoagulants (e.g., warfarin), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen), or selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine) because the risk of bleeding may be increased.
  • Anticholinergics (e.g., benztropine) or carbonic anhydrase inhibitors (e.g., acetazolamide, dichlorphenamide, zonisamide) because the risk of decreased sweating may be increased.
  • Valproic acid because the risk of high blood ammonia levels or low body temperature may be increased.
  • Pioglitazone because blood glucose control may be altered; monitor your blood sugar carefully if you use topiramate with pioglitazone.
  • Hydrochlorothiazide or metformin because they may increase the risk of topiramate’s side effects.
  • Carbamazepine or hydantoins (e.g., phenytoin) because they may decrease topiramate’s effectiveness.
  • Amitriptyline or lithium because the risk of their side effects may be increased by topiramate.
  • Cabazitaxel, hormonal birth control (e.g., birth control pills), or ulipristal because their effectiveness may be decreased by topiramate.

Does food or alcohol interact with topiramate?

Topiramate may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with topiramate?

Topiramate may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using topiramate.

What is the dose of topiramate for an adult?

Maintenance dose: 50 mg orally 2 times daily, in the morning and in the evening.

Titration to 100 mg:

  • Week 1: 25 mg orally once daily in the evening
  • Week 2: 25 mg orally 2 times a day, in the morning and in the evening.
  • Week 3: 25 mg orally in the morning and 50 mg orally in the evening.
  • Week 4: 50 mg orally in the morning and 50 mg orally in the evening.

Longer intervals between dose adjustments may be used as needed.

What is the dose of topiramate for a child?

For seizures (taken with other medicines):

Children 2 years of age and older—At first, 25 milligrams (mg) once a day in the evening. Your doctor may adjust the dose as needed. However, the dose is usually not more than 5 to 9 mg per kilogram (kg) of body weight per day.

Children younger than 2 years of age—Use is not recommended.

For seizures (taken alone):

Children younger than 10 years of age—Use and dose must be determined by your doctor.

For migraine headaches:

Children younger than 12 years of age—Use and dose must be determined by your doctor.

How is topiramate available?

Topiramate is available in the following dosage forms and strengths:

  • Capsule 25 mg; 50 mg; 100 mg; 150 mg; 200 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of topiramate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 1, 2017 | Last Modified: August 1, 2017

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