Description
Topiramate is used alone or with other medications to treat certain types of seizures in adults and children at least 2 years old. Some brand forms of topiramate extended-release capsule are used only in adults and children who are at least 6 years old.
Topiramate is also used to prevent migraine headaches in adults and children who are at least 12 years old.
Topiramate may also be used for purposes not listed in this medication guide.
Topiramate side effects
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.
Topiramate may cause serious side effects. Call your doctor at once if you have:
- changes in your menstrual bleeding;
- a skin rash, no matter how mild;
- dizziness or loss of coordination;
- tiredness, cold feeling;
- blurred vision, eye pain or redness, seeing halos around lights, or sudden vision loss (can be permanent if not treated quickly);
- confusion, problems with thinking or memory, trouble concentrating, problems with speech;
- decreased sweating, feeling very hot;
- signs of a kidney stone–pain in your side or lower back, blood in your urine, painful or difficult urination;
- signs of metabolic acidosis–confusion, vomiting, lack of energy, irregular heartbeats; or
- high levels of ammonia in your blood–vomiting, unexplained weakness, feeling like you might pass out, change in your mental state.
Topiramate can affect growth in children. Your child’s height and weight may be checked often. Tell your doctor if your child is not growing at a normal rate while using topiramate long-term.
Common side effects of topiramate may include:
- dizziness, drowsiness, tiredness, slow reactions;
- problems with speech, memory, or vision;
- numbness, tingling, burning pain in your arms and legs, decreased sensation (especially in the skin);
- changes in your sense of taste, feeling nervous;
- nausea, diarrhea, stomach pain, loss of appetite;
- fever, weight loss; or
- cold symptoms such as stuffy nose, sneezing, sore thro
Warnings
Topiramate may cause vision problems that can lead to permanent vision loss. Call your doctor right away if you have any eye pain or redness or any changes in your vision.
Topiramate may cause decreased sweating and increased body temperature. Children and people exposed to hot weather may be more likely to have this side effect.
Some people have thoughts about suicide while taking topiramate. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Topiramate can decrease bone mineral density, which may increase the risk of developing osteoporosis when the medicine is used in children over long periods of time.
Before taking this medicine
You should not use topiramate if you are allergic to it.
Tell your doctor if you have or have ever had:
- glaucoma or other eye problems;
- high blood levels of ammonia;
- metabolic acidosis (high levels of acid in your blood);
- lung disease, breathing problems;
- depression, mood changes, or suicidal thoughts or actions;
- a growth problem;
- diarrhea;
- a planned surgery;
- kidney stones;
- a bone disorder that causes soft or weak bones or low bone mineral density;
- follow a ketogenic diet (high-fat, high-protein, low-carb);
- liver disease; or
- kidney disease (or if you are on dialysis).
Taking topiramate may increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children. Ask your doctor about your individual risk.
Some people have thoughts about suicide while taking topiramate. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.
Tell your doctor if you are pregnant or plan to become pregnant. Your doctor should determine whether you need topiramate. Taking topiramate during pregnancy may cause birth defects or medical problems in the baby. There may be other medications that are safer to use during pregnancy.
You must use effective birth control while using topiramate. Topiramate can make certain birth control less effective. Ask your doctor about other birth control options.
If you are pregnant, your name may be listed on a pregnancy registry to track the effects of topiramate on the baby.
Ask a doctor if it is safe to breastfeed while using topiramate.
How should I take topiramate?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
You may take topiramate with or without food.
Measure liquid medicine with the supplied measuring device (not a kitchen spoon).
Drink plenty of liquids while you are taking topiramate to help prevent kidney stones.
Certain brand forms can only be swallowed whole. If you are unable to swallow a tablet or capsule whole, read and carefully follow the Instructions for Use provided to you on how to prepare and take topiramate. Ask a doctor or pharmacist if you do not understand these instructions.
Doses are based on weight in children and teenagers. Your child’s dose may change if the child gains or loses weight.
You may need blood tests before and during treatment with topiramate, and your next dose may be changed based on the results. Your doctor will need to check your progress on a regular basis. Keep all follow-up visits to your doctor.
You should not stop using topiramate suddenly. Follow your doctor’s instructions about tapering your dose.
Call your doctor if your symptoms do not improve, or if they get worse.
Store tightly closed at room temperature, away from moisture, heat, and light. Do not allow the liquid medicine to freeze. Throw away any unused liquid medicine 90 days after opening the bottle.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 6 hours. Do not take two doses at one time.
For extended-release capsule: Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal.
What should I avoid while taking topiramate?
Do not drink alcohol. Dangerous side effects could occur. Certain brand forms of topiramate must be taken 6 hours before or after drinking alcohol.
Avoid becoming overheated or dehydrated in hot weather. Topiramate can increase body temperature and decrease sweating, leading to life-threatening dehydration (especially in children).
Avoid the use of a ketogenic or “ketosis” diet (high in fat, low in carbohydrates) while you are taking topiramate.
Avoid driving or hazardous activity until you know how topiramate will affect you. This medicine may cause dizziness, blurred vision, balance or memory problems and this may impair your reactions or cause falls, accidents, or severe injuries.
What other drugs will affect topiramate?
Using topiramate with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Tell your doctor about all your other medicines, especially:
- hydrochlorothiazide;
- acetazolamide, or other glaucoma medications, including eye drops;
- birth control that contains hormones (such as pills, implants, patches or injections); or
- anticonvulsants (antiepileptics)–phenytoin, carbamazepine, zonisamide, valproic acid.
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