TOPIRAMATE- Topamax, Topamax Sprinkle Capsules

Habit forming? No
Prescription needed? Yes
Available as generic? Yes
Drug class: Anticonvulsant, antiepileptic

Treatment for partial (focal) epileptic seizures. May be used alone or in combination with other antiepileptic drugs.

- Prophylaxis (prevention) of migraine headaches in adults.

Tablet: Swallow the tablets whole with a drink of water, do not crush or chew Topamax (the tablet has a bitter taste). Topamax may be taken with or without food and on a full or empty stomach.

- Sprinkle capsules: Can be swallowed whole or opened carefully and the contents sprinkled on a small amount of soft food, such as applesauce, pudding, ice cream, oatmeal, or yogurt. Swallow this mixture immediately. Do not chew or store Topamax for later use.

When to take TOPAMAX:

- Your doctor will determine the best schedule.

- Topamax dosages will be increased rapidly over the first weeks of use. Further increases may be necessary to achieve maximum benefits.

If you forget a TOPAMAX dose:

- Take as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait for your next scheduled dose (don't double this dose).

What TOPAMAX does:

- The exact mechanism of the anticonvulsant effect is unknown. It appears to block the spread of seizures rather than raise the seizure threshold like other anticonvulsants. Topiramate's anticonvulsant actions involve several mechanisms.

Time lapse before drug works:

- Topamax may take several weeks for effectiveness.

Don't take TOPAMAX with:

- Any other medicine or any dietary supplement without consulting your doctor or pharmacist.

SYMPTOMS: Slow or Irregular heartbeat, confusion, dizziness, faintness, unusual tiredness or weakness, blue skin or fingernails, breathing difficulty, coma.


In case of overdose, see previous column.

Common TOPAMAX Side Effects:  

Burning, prickling, or tingling sensations; clumsiness or unsteadiness; confusion; continuous, uncontrolled back-and-forth or rolling eye movements; dizziness; double vision or other vision problems; drowsiness; generalized slowing of mental and physical activity; memory problems; menstrual changes; menstrual pain; nervousness; speech or language problems; trouble in concentrating or paying attention; unusual tiredness or weakness. Breast pain in women, nausea, tremor.

Infrequent TOPAMAX Side Effects:

Abdominal pain, fever, chills, sore throat, lessening of sensations or perception; loss of appetite; mood or mental changes (such as aggression, agitation, apathy, irritability, and depression) red, irritated, or bleeding gums; weight loss.  Back pain, chest pain, constipation, heartburn, Hot flushes, increased sweating, leg pain.

Rare TOPAMAX Side Effects:

Eye pain, frequent or difficult urination, bloody urine, hearing loss, itching, unsteadiness, loss of bladder control, lower back or side pain, nosebleeds, pale skin, red or irritated eyes, ringing or buzzing in ears, skin rash, swelling, troubled breathing.

Don't take TOPAMAX if:

- You are allergic to topiramate.

Before you start TOPAMAX, consult your doctor If:

- You have a history of liver disease.

- You have kidney disease or kidney stones (nephrolithiasis).

- You are allergic to any medication, food or other substance.

- You have any other medical problems.

Over age 60:

- No special problems expected.


- Decide with your doctor if drug benefits justify risks to unborn child.


- It is unknown if Topamax passes into milk.

- Avoid Topamax or discontinue nursing until you finish medicine.

- Consult doctor for advice on maintaining milk supply.

Infants & children:

- Topamax is approved for use from age 2 on.

- Topamax dose is according to body weight.

- This medicine is not expected to cause different side effects or problems in children than it does in adults.

Prolonged TOPAMAX use:

- No special problems expected.

- Follow-up laboratory blood studies may be recommended by your doctor.

Skin & sunlight:

- No problems expected.

Driving, piloting or hazardous work:

- Don't drive or pilot aircraft until you learn how medicine affects you.

- Don't work around dangerous machinery.

- Don't climb ladders or work in high places.

- Danger increases if you drink alcohol or take other medicines affecting alertness and reflexes.

Discontinuing TOPAMAX:

- Don't discontinue without doctor's approval due to risk of increased seizure activity.

- The dosage may need to be gradually decreased before stopping Topamax completely.


- Advise any doctor or dentist whom you consult that you take Topamax.

- Drink plenty of fluids while taking topiramate.

- If you have had kidney stones in the past, this will help to reduce your chances of forming kidney stones.

- Topiramate may be used with other anticonvulsant drugs and additional side effects may also occur. If they do, discuss them with your doctor.

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