topiramate

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

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What is topiramate?

Topiramate is a seizure medicine, also called an anticonvulsant. Topiramate is used to treat certain types of seizures in adults and children who are at least 2 years old. Trokendi XR is for use in adults and children who are at least 6 years old.

Some brands of topiramate are also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. These medicines will only prevent migraine headaches or reduce the number of attacks, but 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?

Tell your doctor if you are sick with diarrhea, or if you have ever had:

• glaucoma or other eye problems;
• metabolic acidosis (high levels of acid in your blood);
• kidney disease, kidney stones, or dialysis;
• lung disease, breathing problems;
• mood problems, depression, or suicidal thoughts or actions;
• liver disease;
• a growth disorder; or
• soft or brittle bones (osteoporosis, osteomalacia).

Topiramate can increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children or harm to an unborn baby. You may need blood tests to make sure you do not have metabolic acidosis, especially if you are pregnant.

Some people have thoughts about suicide while taking an anticonvulsant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking topiramate during pregnancy may increase the risk of cleft lip and/or cleft palate, a birth defect that can develop early in pregnancy even before you know you are pregnant. However, having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant.

If you are not pregnant or planning to become pregnant, use effective birth control to prevent pregnancy while taking topiramate.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of topiramate on the baby.

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.

Topiramate can be taken with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

If you cannot swallow a Qudexy XR or Topamax Sprinkle Capsule whole, open it and sprinkle the medicine into a spoonful of applesauce or other soft food. Swallow the mixture right away without chewing. Do not save it for later use.

Topiramate doses are sometimes based on weight in children. Your child's dose needs may change if the child gains or loses weight.

You will need frequent medical tests. If you need surgery, tell the surgeon ahead of time that you are using topiramate. Any medical care provider who treats you should know that you take seizure medication.

Do not stop using topiramate suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

What happens if I miss a dose?

Take the medicine as soon as you can. Do not take two doses at one time. Skip a missed Topamax dose if your next dose is due in less than 6 hours. Call your doctor if you have missed more than one dose.

What happens if I overdose?

What should I avoid while taking topiramate?

Avoid the use of a ketogenic or "ketosis" diet (high in fat, low in carbohydrates) while you are taking topiramate.

Also avoid activities that could be dangerous if you have an unexpected seizure, such as swimming or climbing in high places.

What are the possible side effects of topiramate?

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.

• a skin rash, no matter how mild;
• dizziness or loss of coordination;
• vision problems, blurred vision, eye pain or redness, sudden vision loss (can be permanent if not treated quickly);
• confusion, problems with thinking or memory, trouble concentrating, problems with speech;
• dehydration symptoms --decreased sweating, high fever, hot and dry skin;
• signs of a kidney stone --severe pain in your side or lower back, painful or difficult urination;
• signs of too much acid in your blood --irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or
• signs of too much ammonia in your blood --vomiting, unexplained weakness, feeling like you might pass out.

Common side effects may include:

• dizziness, drowsiness, tiredness, slow reactions;
• problems with speech or memory, abnormal vision;
• numbness or tingling 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 throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect topiramate?

Tell your doctor about all your other medicines, especially:

• zonisamide;
• birth control pills;
• divalproex, valproic acid; or
• other glaucoma medications, including eye drops.

This list is not complete. Other drugs may affect topiramate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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