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Pronunciation:toe PYRE a mate
Brand:Topamax, Topamax Sprinkle, Topiragen

Topamax 100 mg

round, yellow, imprinted with TOPAMAX, 100

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Topamax 200 mg

round, peach, imprinted with TOPAMAX, 200

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Topamax 25 mg

round, white, imprinted with TOP, 25

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Topiramate 100 mg-APO

round, yellow, imprinted with APO, TP 100

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Topiramate 100 mg-TEV

oblong, yellow, imprinted with 93, 7219

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Topiramate 15 mg-TEV

white, imprinted with 93 7335

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Topiramate 200 mg-APO

round, pink, imprinted with APO, TP 200

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Topiramate 200 mg-TEV

oblong, pink, imprinted with 93, 7220

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Topiramate 25 mg-APO

round, white, imprinted with APO, TP 25

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Topiramate 25 mg-TEV

oblong, white, imprinted with 93, 155

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Topiramate 50 mg-APO

round, white, imprinted with APO, TP 50

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Topiramate 50 mg-TEV

oblong, yellow, imprinted with 93, 7540

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

emtTopiramate may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking topiramate for seizures. Do not start or stop taking topiramate during pregnancy without your doctor's advice.
emtSeek 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.
donotDo not stop using topiramate without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using topiramate suddenly. You may need to use less and less before you stop the medication completely.
emtContact your doctor if your seizures get worse or you have them more often while taking topiramate.

What is topiramate?

Topiramate is a seizure medication, also called an anticonvulsant.

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

Topiramate is also used to prevent migraine headaches in adults. 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 purposes not listed in this medication guide.

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

donotYou should not use topiramate if you are allergic to it.

To make sure you can safely take topiramate, tell your doctor if you have any of these other conditions:

  • 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;
  • asthma, emphysema, or other breathing disorder; or
  • if you are pregnant or plan to become pregnant while using topiramate.

You may have thoughts about suicide while taking topiramate. 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.

nopregFDA pregnancy category D. Taking topiramate during pregnancy may increase the risk of cleft lip and/or cleft palate in the newborn. Do not start taking topiramate without telling your doctor if you are pregnant or planning to become pregnant. Use effective birth control while you are taking topiramate.

Seizure control is very important during pregnancy. The benefit of preventing seizures may outweigh any risks posed by taking topiramate. Follow your doctor's instructions about taking topiramate while you are pregnant.

emtAlthough topiramate may harm an unborn baby, having a seizure during pregnancy could harm both mother and baby. If you become pregnant while taking topiramate, do not stop taking the medicine without your doctor's advice.
bcpTopiramate 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 topiramate. If you are not planning a pregnancy while taking topiramate, use effective birth control, and tell your doctor if you become pregnant during treatment.
nobrfeedTopiramate can pass into breast milk and may 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 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.

Topiramate can be taken with or without food. The topiramate tablet should be swallowed whole. It has a bitter taste when chewed or broken.

You may open the topiramate 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.

waterDrink plenty of liquids while you are taking topiramate. 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.
emtIf you need surgery, tell the surgeon ahead of time that you are using topiramate. You may need to stop using the medicine for a short time.
donotDo not stop using topiramate without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using topiramate suddenly. You may need to use less and less before you stop the medication completely.
emtContact your doctor if your seizures get worse or you have them more often while taking topiramate. To be sure this medication 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.
emtWear a medical alert tag or carry an ID card stating that you take topiramate. Any medical care provider or dentist who treats you should know that you are taking a seizure medication.
rtStore at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

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.

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

What happens if I overdose?

emtSeek 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 topiramate?

dizzyTopiramate 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.
noalcoholAvoid drinking alcohol. It can increase certain side effects of topiramate, and can also increase your risk of a seizure.

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

What are the possible side effects of topiramate?

emtGet 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.
emtReport 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.
donotCall your doctor at once if you have a serious side effect 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,
  • confusion, slowed thinking, memory problems, trouble concentrating, problems with speech or balance;
  • 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 side effects may include:

  • mild dizziness, feeling nervous;
  • numbness or tingly feeling;
  • diarrhea, weight loss; 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.

What other drugs will affect topiramate?

dizzyCold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety can add to sleepiness caused by topiramate. 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:

  • lithium (Eskalith, LithoBid);
  • hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor, Vasoretic, Zestoretic);
  • 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), solifenacin (Vesicare), and others;
  • glaucoma medications such as acetazolamide (Diamox) or methazolamide (Neptazane); or
  • other seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), lamotrigine (Lamictal), phenytoin (Dilantin), divalproex sodium (Depakote), valproic acid (Depakene, Stavzor), or zonisamide (Zonegran).

This list is not complete and other drugs may interact with topiramate. 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.

Where can I get more information?

Your pharmacist can provide more information about topiramate.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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