Topiramate is used alone or with other medications to prevent and control seizures (epilepsy). This medication is also used to prevent migraine headaches and reduce how often you may get them. Topiramate will not work to treat a migraine headache once it occurs. If you get a migraine headache, treat it as directed by your doctor (e.g., take pain medications, decrease sound and light).

Topiramate is an anti-seizure medication (anticonvulsant) that works in several ways to prevent seizures and migraines.

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using topiramate and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.

Take this medication by mouth with or without food, usually twice daily or as directed by your doctor. Swallow the tablets whole. Do not crush, chew or break the tablets because they have a bitter taste. To prevent kidney stones from forming, drink plenty of liquids while taking this medication unless your doctor instructs you otherwise.

The dosage is based on your medical condition and response to therapy. In children, dosage may also be based on body weight. Your doctor may gradually increase your dose to lower your risk of side effects such as drowsiness and memory problems. It may take several weeks to reach the best dose for you. Take this medication exactly as directed.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition persists or worsens.

Weakness, tiredness, drowsiness, dizziness, confusion, difficulty concentrating, tingling of the hands/feet, loss of appetite, diarrhea, impotence, and weight loss may occur. If any of these symptoms persist or worsen, notify your doctor promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (e.g., memory problems, nervousness), slow/unsteady movement, speech/language problems.

This medication rarely may cause mood or behavior changes, such as anxiety, agitation, hostility, pressured/rapid speech, or thoughts of suicide. Tell your doctor immediately if you develop unusual (possibly sudden) mood changes.

Tell your doctor immediately if any of these rare but very serious side effects occur: severe back/side pain, rapid breathing, bone pain/breakage, loss of consciousness, fast/slow/irregular heartbeat, stomach/abdominal pain, painful urination, bloody or pink-colored urine, chest pain.

Seek immediate medical attention if either of these rare but very serious eye problems occur: sudden vision changes (e.g., blurred vision), eye pain/redness.

This medication can rarely cause a serious metabolic problem (hyperammonemia), especially if you are also taking valproic acid. Tell your doctor immediately if you experience sudden/unexplained tiredness, vomiting, or mental changes (e.g., difficulty staying awake).

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking topiramate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye problems (e.g., glaucoma), kidney problems, liver problems, severe lung/breathing problems, metabolism problems (e.g., metabolic acidosis, born with metabolism disease), long-term diarrhea problem, any special diet (e.g., high-protein, ketogenic).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

Topiramate can infrequently cause decreased sweating, which could raise your body temperature to unsafe levels (hyperthermia). The risk of this serious side effect is greater in hot weather and/or during vigorous exercise, especially in children. Drink plenty of fluids and dress lightly in hot weather or when exercising. Check carefully for signs of decreased sweating. If this occurs, immediately stop exercising and seek cooler shelter. Seek immediate medical attention if your body temperature is above normal or if you have mental/mood changes, headache, or dizziness. Consult your doctor for more details.

Before having surgery, tell your doctor or dentist that you are using this medication.

Monitor your weight while taking this medication, and share the results with your doctor. If you lose weight unexpectedly, discuss with your doctor. You may need to change your diet.

Caution is advised when using this drug in children because they may be more sensitive to its side effects, especially effects on bone health, growth rate, and temperature. Consult your doctor or pharmacist for more details.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at greater risk for side effects such as drowsiness and dizziness while using this drug.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: amitriptyline, carbamazepine, metformin, phenytoin, pioglitazone, risperidone, valproic acid, "water pills" (diuretics such as hydrochlorothiazide, acetazolamide, dichlorphenamide), other drugs that cause decreased sweating (e.g., anticholinergics such as belladonna alkaloids/scopolamine, antihistamines such as hydroxyzine, phenothiazines such as chlorpromazine).

This medication may decrease the effectiveness of combination-type birth control (e.g., pills, patches). This can result in pregnancy. You may need to use an additional form of reliable birth control while using this medication. Report any unusual vaginal bleeding to your doctor. Consult your doctor or pharmacist for details.

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., phenobarbital), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., haloperidol, nortriptyline, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

Do not share this medication with others.

Laboratory and/or medical tests (e.g., eye exams, serum bicarbonate level) should be performed to monitor your progress and check for side effects.

If you miss a dose, take it as soon as you remember. If it is within 6 hours of your next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. If you have missed more than one dose, you should call your doctor for advice.

Store in a tightly closed container at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.