Topamax

Topamax

Generic Name: topiramate (toe PYRE a mate)

Brand Names: Topamax, Topamax Sprinkle, Topiragen

What is Topamax?

Topamax (topiramate) is a seizure medication, also called an anticonvulsant.

Topamax is used alone to treat seizures in adults and children who are at least 10 years old.

Topamax is used in combination with other medications to treat seizures in adults and children who are at least 2 years old.

Topamax is also used to prevent migraine headaches in adults. It will only prevent migraine headaches or reduce the number of attacks. It will not treat a headache that has already begun.

Topamax may also be used for purposes not listed in this medication guide.

Important information about Topamax

Do not stop using Topamax without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Topamax suddenly. You may need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking Topamax.

Seek emergency medical attention if you have a sudden change in vision or pain around or behind the eyes. These may be early signs of a serious and permanent side effect on your vision.

You may have thoughts about suicide while taking Topamax. Tell your doctor if you have new or worsening symptoms of depression, anxiety, or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits.

Wear a medical alert tag or carry an ID card stating that you take Topamax. Any medical care provider or dentist who treats you should know that you are taking a seizure medication.

Ketogenic or "ketosis" diets that are high in protein and low in carbohydrates can increase the risk of kidney stones. Avoid the use of such diets while you are taking Topamax.

Before taking Topamax

You should not use Topamax if you are allergic to topiramate.

If you have any of these other conditions, you may need a Topamax dose adjustment or special tests:

kidney disease or a history of kidney stones;

liver disease;

glaucoma;

a history of depression or suicide attempt;

a growth disorder;

a history of metabolic acidosis;

osteoporosis or low bone density; or

asthma, emphysema, or other breathing disorder.

You may have thoughts about suicide while taking Topamax. Tell your doctor if you have new or worsening symptoms of depression, anxiety, or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits.

FDA pregnancy category D. Topamax can cause birth defects in an unborn baby. Do not use Topamax without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Topamax can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking Topamax. It is not known whether topiramate passes into breast milk or if it could harm a nursing baby. Do not use Topamax without telling your doctor if you are breast-feeding a baby.

See also: Topamax pregnancy and breastfeeding warnings (in more detail)

How should I take Topamax?

Take Topamax exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Topamax can be taken with or without food.

The Topamax tablet should be swallowed whole. It has a bitter taste when chewed or broken.

You may open the Topamax capsule and sprinkle the medicine into a spoonful of applesauce or other soft food to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

To be sure Topamax is not causing harmful effects, your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Topamax. You may need to stop using the medicine for a short time. Do not stop using Topamax without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Topamax suddenly. You may need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking Topamax. Wear a medical alert tag or carry an ID card stating that you take Topamax. Any medical care provider or dentist who treats you should know that you are taking a seizure medication. Drink plenty of liquids while you are taking Topamax. This will lower your risk of having kidney stones or an electrolyte imbalance. Call your doctor if you have ongoing vomiting or diarrhea. You can easily become dehydrated while taking this medication.

Store Topamax at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

See also: Topamax dosage (in more detail)

What happens if I miss a dose?

If you are less than 6 hours late in taking your medicine, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Call your doctor for instructions if you miss two or more doses.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, dizziness, agitation or depression, blurred vision, problems with speech or balance, stomach pain, chest pain, fast or pounding heartbeats, feeling light-headed, fainting, and seizure (convulsions).

What should I avoid while taking Topamax?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Topamax can decrease sweating and you may be more prone to heat stroke.

Topamax may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Avoid drinking alcohol. It can increase certain side effects of Topamax, and can also increase your risk of a seizure.

Ketogenic or "ketosis" diets that are high in protein and low in carbohydrates can increase the risk of kidney stones. Avoid the use of such diets while you are taking Topamax.

Topamax side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Topamax: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have a serious side effect while using Topamax, such as:

sudden vision loss, pain around or behind your eyes;

dry mouth, increased thirst, drowsiness, decreased sweating, increased body temperature, and hot, dry skin,

slowed thinking, memory problems, trouble concentrating;

problems with speech or balance;

confusion, mood changes, unusual behavior, thoughts of suicide or hurting yourself;

vomiting, loss of appetite, tired feeling, irregular heartbeats, feeling like you might pass out; or

severe pain in your side or lower back, painful or difficult urination.

Less serious Topamax side effects may include:

mild dizziness;

numbness or tingly feeling;

diarrhea, weight loss;

feeling nervous;

change in your sense of taste; or

cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Topamax side effects (in more detail)

What other drugs will affect Topamax?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety can add to sleepiness caused by Topamax. Tell your doctor if you regularly use any of these medicines, or any other seizure medication.

Tell your doctor about all other medicines you use, especially:

glycopyrrolate (Robinul);

lithium (Eskalith, LithoBid);

hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic);

mepenzolate (Cantil);

metformin (Glucophage, Actoplus Met, Avandamet, Fortamet, Janumet, PrandiMet, Riomet);

atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

glaucoma medications such as acetazolamide (Diamox) or methazolamide (Neptazane);

irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro-Banthine); or

other seizure medications such as carbamazepine (Carbatrol, Tegretol), lamotrigine (Lamictal), phenytoin (Dilantin), valproic acid (Depakote, Depakene), or zonisamide (Zonegran).

This list is not complete and other drugs may interact with Topamax. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Topamax resources

Topamax Side Effects (in More Detail)

Topamax Dosage

Topamax Use in Pregnancy & Breastfeeding

Drug Images

Topamax Drug Interactions

Topamax Support Group

151 Reviews for Topamax - Add your own review/rating

Topamax Prescribing Information (FDA)

Topamax MedFacts Consumer Leaflet (Wolters Kluwer)

Topamax Monograph (AHFS DI)

Topamax Advanced Consumer (Micromedex) - Includes Dosage Information

Topiramate Prescribing Information (FDA)

Topiramate Professional Patient Advice (Wolters Kluwer)

Topiragen Prescribing Information (FDA)

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Where can I get more information?

Your pharmacist can provide more information about Topamax.