What is topiramate?
Topiramate is a seizure medication, also called an anticonvulsant.
Topiramate is used alone or in combination with other medications to prevent seizures in
adults and children who are at least 2 years old.
Topiramate is also used to prevent migraine headaches. Topiramate
will only
prevent
migraine headaches or reduce the number of attacks. It
will not treat
a headache that has already begun.
Topiramate may also be used for other purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking topiramate?
Do not use this medication if you are allergic to topiramate.
Before taking topiramate, tell your doctor if you are allergic to any drugs, or if you have:
-
kidney disease or a history of kidney stones;
-
liver disease;
-
glaucoma;
-
asthma, emphysema, or bronchitis; or
-
if you have recently had surgery.
FDA pregnancy category C. This medication may be harmful to
an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during
treatment.
You may have thoughts about suicide while taking this medication. Tell your doctor if
you have new or worsening depression or suicidal thoughts during the first several months of
treatment, or whenever your dose is changed.
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. Do not miss any scheduled
appointments.
Topiramate can make birth control pills less effective. Talk with your doctor about
other forms of birth control if you are trying to prevent pregnancy while taking topiramate.
It is not known whether topiramate passes into breast milk or if it could harm a
nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a
baby.
How should I take topiramate?
Take this medication exactly as it was prescribed for you. Do not take the medication in
larger amounts, or take it for longer than recommended by your doctor. Follow the directions on
your prescription label. Your doctor may occasionally change your dose to make sure you get the
best results from this medication.
Topiramate can be taken with or without food.
Take the medicine with a full glass of water.
The topiramate
tablet
should be swallowed whole. It has a bitter taste
when chewed or broken.
To make the topiramate
capsule
easier to swallow, you may open the
capsule and sprinkle the medicine into a spoonful of applesauce, custard, ice cream, oatmeal,
pudding, or yogurt. Swallow this mixture right away without chewing. Do not save the mixture
for later use.
To be sure this medication is not causing harmful effects, your blood will need to be
tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss
any scheduled visits to your doctor.
If you need to have any type of surgery, tell the surgeon ahead of time that you are using
topiramate. You may need to stop using the medicine for a short time.
Do not stop taking topiramate without first talking to your doctor, even if you feel
better. You may have increased seizures if you stop taking topiramate suddenly. You will 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 topiramate.
Carry an ID card or wear a medical alert bracelet stating that you are taking
topiramate, in case of emergency. Any doctor, dentist, or emergency medical care provider who
treats you should know that you are taking a seizure medication.
Drink extra fluids each day while you are taking topiramate. This will lower your
risk of having kidney stones or an electrolyte imbalance. Vomiting or diarrhea can lead to
dehydration and cause an electrolyte imbalance. Call your doctor if you have ongoing vomiting
or diarrhea while taking topiramate.
Store topiramate at room temperature away from moisture and heat.
What happens if I miss a dose of topiramate?
Take the missed dose as soon as you remember. If it is almost time for your next dose,
skip the missed dose and take the medicine at your next regularly scheduled time.
Do
not
take extra medicine to make up the missed dose.
Where can I get more information about topiramate?
Your pharmacist has information about topiramate written for health professionals that you may read.
What are the possible side effects of topiramate?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any new or worsening symptoms such as: mood or
behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive
(mentally or physically), or have thoughts about suicide or hurting yourself.
Stop taking topiramate and call your doctor at once if you have any of these serious
side effects:
-
sudden vision loss, pain around or behind your eyes;
-
dry mouth, increased thirst, confusion, drowsiness,
decreased sweating, increased body temperature, and hot, dry skin,
-
nausea, vomiting, increased urination, muscle pain or
weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions); or
-
severe pain in your side or lower back, painful or difficult
urination.
Less serious side effects may include:
-
slowed thinking, memory problems, trouble concentrating;
-
problems with speech or balance;
-
numbness or tingling;
-
sleep problems (insomnia);
-
tired feeling;
-
headache, dizziness; or
-
loss of appetite, weight loss.
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.
What is the most important information I should know about topiramate?
Seek emergency medical attention if you have a sudden change in vision and pain
around or behind the eyes. These may be early signs of a serious side effect of topiramate.
Do not stop taking topiramate without first talking to your doctor, even if you feel
better. You may have increased seizures if you stop taking topiramate suddenly. You will 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 topiramate.
You may have thoughts about suicide while taking this medication. Your doctor will
need to check you at regular visits. Do not miss any scheduled appointments.
Call your doctor at once if you have any new or worsening symptoms such as: mood
or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive
(mentally or physically), or have thoughts about suicide or hurting yourself.
Carry an ID card or wear a medical alert bracelet stating that you are taking
topiramate, in case of emergency. Any doctor, dentist, or emergency medical care provider who
treats you should know that you are taking a seizure medication.
Topiramate can cause side effects that may impair your vision 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 some of the side effects of topiramate, and
can also increase the 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 topiramate.
What should I avoid while taking topiramate?
Topiramate can cause side effects that may impair your vision 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 some of the side effects of topiramate, and
can also increase the risk of a seizure.
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and
medicine for seizures, depression or anxiety can add to sleepiness caused by topiramate. Tell
your doctor if you regularly use any of these other medicines.
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 topiramate.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Drink
extra fluids in these situations.
What other drugs will affect topiramate?
Before taking topiramate, tell your doctor if you are taking any of the following
medicines:
-
amitriptyline (Elavil, Etrafon);
-
atropine (Donnatal, and others);
-
benztropine (Cogentin);
-
glycopyrrolate (Robinul);
-
hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar,
Lopressor, Vasoretic, Zestoretic);
-
methscopolamine (Pamine) or scopolamine
(Transderm-Scop);
-
risperidone (Risperdal);
-
bladder or urinary medications such as darifenacin
(Enablex), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
-
bronchodilators such as ipratropium (Atrovent) or
tiotropium (Spiriva);
-
diabetes medicine you take by mouth, such as pioglitazone
(Actos) or metformin (Actoplus Met, Avandamet, Glucophage, Fortamet);
-
glaucoma medications such as acetazolamide (Diamox),
methazolamide (Neptazane), or dichlorphenamide (Daranide);
-
irritable bowel medications such as dicyclomine (Bentyl),
hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), propantheline (Pro-Banthine); or
-
other seizure medications such as carbamazepine
(Carbatrol, Tegretol), lamotrigine (Lamictal), phenytoin (Dilantin), or valproic acid (Depakote,
Depakene).
This list is not complete and there may be other drugs that can interact
with topiramate. Tell your doctor about all the prescription and over-the-counter medications
you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start using a new medication without telling your doctor.
What happens if I have an overdose of topiramate?
