Topiramate

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Eprontia; Qudexy XR; Topamax; Topamax Sprinkle; Trokendi XR

Brand Names: Canada

ACH-Topiramate; AG-Topiramate; APO-Topiramate; Auro-Topiramate; DOM-Topiramate [DSC]; GLN-Topiramate; JAMP-Topiramate; MINT-Topiramate; MYLAN-Topiramate; NRA-Topiramate; PMS-Topiramate; PRO-Topiramate; SANDOZ Topiramate [DSC]; TEVA-Topiramate; Topamax; Topamax Sprinkle

What is this drug used for?

• It is used to treat seizures.
• It is used to prevent migraine headaches.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

This drug may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
• Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of seizures. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
• Have your blood work and other lab tests checked as you have been told by your doctor.
• Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
• This drug may cause an acid blood problem (metabolic acidosis). The chance may be higher in children and in people with kidney problems, breathing problems, or diarrhea. The chance may also be higher if you take certain other drugs, if you have surgery, or if you are on a ketogenic diet. Over time, metabolic acidosis can cause kidney stones, bone problems, or growth problems in children.
• This drug may raise the chance of bleeding. Sometimes, bleeding can be life-threatening. Talk with the doctor.
• Taking this drug with valproic acid can cause low body temperature. This can also cause tiredness, confusion, or coma. Talk with the doctor.
• If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.
• This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
• Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use some other kind of birth control also like a condom when taking this drug.
• If you are taking hormone-based birth control and you have any change in your bleeding pattern, talk with your doctor.
• This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.
• If you are able to get pregnant but do not want to get pregnant, use birth control that you can trust to prevent pregnancy while taking this drug.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Extended-release capsules:

• Avoid drinking alcohol while taking this drug. This is most important within 6 hours before or 6 hours after taking this drug.

All other products:

• Avoid drinking alcohol while taking this drug.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of high ammonia levels like a heartbeat that does not feel normal, breathing that is not normal, feeling confused, pale skin, slow heartbeat, seizures, sweating, throwing up, or twitching.
• Any unexplained bruising or bleeding.
• Feeling confused, not able to focus, or change in behavior.
• Memory problems or loss.
• Trouble speaking.
• Trouble sleeping.
• Change in balance.
• Severe dizziness or passing out.
• Not able to eat.
• Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
• A burning, numbness, or tingling feeling that is not normal.
• Bone pain.
• Chest pain.
• Muscle pain or weakness.
• Shakiness.
• Trouble walking.
• Not able to control eye movements.
• Like other drugs that may be used for seizures, this drug may rarely raise the risk of suicidal thoughts or actions. The risk may be higher in people who have had suicidal thoughts or actions in the past. Call the doctor right away about any new or worse signs like depression; feeling nervous, restless, or grouchy; panic attacks; or other changes in mood or behavior. Call the doctor right away if any suicidal thoughts or actions occur.
• This drug may cause very bad eye problems. If left untreated, this can lead to lasting eyesight loss. Call your doctor right away if you have new eye signs like blurred eyesight or other changes in eyesight, eye pain, or eye redness.
• Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
• Sweating less and high body temperatures have happened with this drug. Sometimes, this has led to the need for treatment in a hospital. Be careful in hot weather and while being active. Call your doctor right away if you have a fever or you do not sweat during activities or in warm temperatures.
• A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
• Change in taste.
• Weight loss.
• Feeling nervous and excitable.
• Feeling dizzy, sleepy, tired, or weak.
• Headache.
• Flushing.
• Signs of a common cold.
• Joint pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All products:

• Take with or without food.
• Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
• Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.

Tablets:

• Swallow whole. Do not chew, break, or crush.

Regular-release sprinkle capsules and extended-release sprinkle capsules:

• You may swallow whole or sprinkle the contents on a spoonful of soft food like applesauce. Do not crush or chew before you swallow.
• If mixed, swallow the mixed drug right away. Do not store for use at a later time.
• Drink fluids right after eating the food and drug mixture to make sure the drug is swallowed.

Extended-release capsules:

• Swallow whole. Do not chew, open, or crush.
• Do not sprinkle this drug on food.

Oral solution:

• Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
• Do not use a household teaspoon or tablespoon to measure this drug. Doing so could lead to the dose being too high.

What do I do if I miss a dose?

Extended-release capsules:

• Call your doctor to find out what to do.

Extended-release sprinkle capsules:

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.
• If you miss 2 doses, call your doctor.

All other products:

• Take a missed dose as soon as you think about it.
• If it is less than 6 hours until the next dose, skip the missed dose and go back to the normal time.
• Do not take 2 doses at the same time or extra doses.
• If you miss 2 doses, call your doctor.

How do I store and/or throw out this drug?

All products:

• Store at room temperature in a dry place. Do not store in a bathroom.
• Keep lid tightly closed.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Oral solution:

• Throw away any part not used 90 days after opening.

Extended-release capsules:

• Protect from light.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else’s drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
• This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-10-09

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