What is the most important information I should know about topiramate?

• Seek immediate medical attention if you experience blurred vision, changes in vision, or pain in or around the eyes during treatment with topiramate. These may be early signs of a serious side effect.
  
  
• Do not stop taking topiramate without first talking to your doctor, even if your symptoms have improved. It is important to continue taking topiramate to prevent seizures from recurring.
  
  
• Carry or wear a medical identification tag to let others know that you are taking topiramate in the case of an emergency.
  
  
• Use caution when driving, operating machinery, or performing other hazardous activities. Topiramate may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
  
  
• Alcohol should be avoided while taking topiramate. Alcohol may cause increased sedation or drowsiness. It may also increase the risk of having a seizure.
  
  
• Drink several extra glasses of fluid each day during treatment with topiramate to minimize the risk of kidney stone formation. Additional fluid may be necessary during hot weather, vigorous exercise, and illness.

What is topiramate?

• Topiramate is used to control seizures. The exact way that it works is unknown. However, it is believed that topiramate alters the chemical impulses in the brain that cause seizures.
  
  
• Topiramate may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking topiramate?

• Before taking topiramate, tell your doctor if you have liver or kidney disease. You may not be able to take topiramate, or you may require a dosage adjustment or special monitoring during treatment.
  
  
• It is not known whether topiramate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or if you could become pregnant during treatment.
  
  
• It is not known whether topiramate passes into breast milk. Do not take topiramate without first talking to your doctor if you are breast-feeding a baby.
  
  
• The safety and effectiveness of topiramate have not been established for children younger than 2 years of age.

How should I take topiramate?

• Take topiramate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
  
  
• Take each dose of topiramate with a full glass of water.
  
  
• The Topamax Sprinkle Capsules may be carefully opened and the contents sprinkled onto a small amount (teaspoon) of soft food. This drug/food mixture should be swallowed immediately, without chewing. The mixture should not be stored for future use. If the mixture is combined in a small container, add some water to the container after the dose has been taken, and drink the water to ensure the whole dose has been taken.
  
  
• Due to their bitter taste, the Topamax tablets should not be broken.
  
  
• Topiramate can be taken with or without food.
  
  
• Carry or wear a medical identification tag to let others know that you are taking this medicine in the case of an emergency.
  
  
• Do not stop taking topiramate without first talking to your doctor, even if your symptoms have improved. It is important to continue taking topiramate to prevent seizures from recurring.
  
  
• Drink several extra glasses of fluid each day during treatment with topiramate to minimize the risk of kidney stone formation. Additional fluid may be necessary during hot weather, vigorous exercise, and illness.
  
  
• Store topiramate at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

• Seek emergency medical treatment.
  
  
• Symptoms of a topiramate overdose are unknown but may include severe drowsiness, poor coordination, tremor, confusion, difficulty speaking, and nausea.

What should I avoid while taking topiramate?

• Use caution when driving, operating machinery, or performing other hazardous activities. Topiramate may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
  
  
• Alcohol should be avoided while taking topiramate. Alcohol may cause increased sedation or drowsiness. It may also increase the risk of having a seizure.
  
  
• Drink several extra glasses of fluid each day during treatment with topiramate to minimize the risk of kidney stone formation. Additional fluid may be necessary during hot weather, vigorous exercise, and illness.
  
  
• Ketogenic diets (high protein, very low carbohydrate diets that may induce ketosis) may increase the risk of kidney stone formation and should be avoided during treatment with topiramate.

What are the possible side effects of topiramate?

• If you experience any of the following serious side effects, stop taking topiramate and seek emergency medical attention:
  
  
  
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
    
    
  • blurred vision, changes in vision, or pain in or around the eyes
    
    
  • worsening of seizures.
  
  
• Other, less serious side effects may be more likely to occur. Continue to take topiramate and talk to your doctor if you experience
  
  
  • dizziness, poor coordination, sluggishness, or drowsiness;
    
    
  • irregular back-and-forth movements of the eyes;
    
    
  • nausea, loss of appetite, or weight loss;
    
    
  • tremor, numbness, or tingling;
    
    
  • confusion, difficulty concentrating or decreased memory;
    
    
  • speech or language difficulties; or
    
    
  • changes in behavior, depression, nervousness, or agitation.
  
  
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect topiramate?

• Before taking topiramate, tell your doctor if you are taking any of the following medicines:
  
  
  
  • another seizure medication such as valproic acid (Depakote, Depakene), carbamazepine (Tegretol, Carbatrol, Epitol), phenytoin (Dilantin), and others;
    
    
  • a carbonic anhydrase inhibitor such as acetazolamide (Diamox), methazolamide (Neptazane), or dichlorphenamide (Daranide); or
    
    
  • digoxin (Lanoxin, Lanoxicaps).
  
  
• You may not be able to take topiramate, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the drugs listed above.
  
  
• Topiramate may decrease the effectiveness of birth control pills. Talk to your doctor about other birth control options to prevent unintended pregnancy.
  
  
• Topiramate may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, pain relievers, sedative (sleep aids), anxiety medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if topiramate is taken with any of these medications.
  
  
• Drugs other than those listed here may also interact with topiramate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Disclaimer

The materials contained on the Epilepsy Newfoundland and Labrador website are to provide general information about epilepsy to the public. The information presented is not intended as medical or legal advice. Epilepsy Newfoundland and Labrador, its employees, board members, medical advisors, volunteers, agents and sponsors do not assume responsibility for inaccuracies or omissions or for the consequences from the use of the information obtained over this site or any links accessed through this site. Epilepsy Newfoundland and Labrador is not liable for any outcome or damages resulting from information in either a direct or indirect form. We recognize that each individual's experience of epilepsy is different. Consult your physician and/or neurologist with any questions you have.