Topiramate

Description

Topiramate is a medicine used in the treatment of seizures (sudden, uncontrolled electrical disturbances in the brain causing abnormal behaviour and loss of consciousness). It is also used to prevent migraine headaches. Topiramate works by reducing the abnormal electrical activity in the brain. Topiramate may cause side effects like nausea, vomiting, fatigue, weight loss, blurred vision, etc. Consult your doctor if these symptoms persist or become severe. Avoid driving vehicles and operating machines as this medicine may cause dizziness or drowsiness. Topiramate may be taken with or without food as directed by your doctor. The dose and duration of treatment will be decided by your doctor based on the severity of your condition. Take this medicine for the recommended duration for better results. Avoid abrupt discontinuation of this medicine without consulting your doctor, as it may cause an increased frequency of seizures. Your doctor may withdraw the medicine gradually over a period to avoid such undesired effects. Topiramate is not recommended for use if you are allergic to it. Inform your doctor if you have blood disorders, depression, liver or kidney problems, or any other medical conditions before taking this medicine. Inform your doctor about all your current medications to avoid any undesired effects. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding before taking this medication.

Side effects

Major & minor side effects for Topiramate

  • Blurred vision
  • Dizziness
  • Unusual tiredness and weakness
  • Stomach pain
  • Loss of appetite
  • Back pain
  • Constipation
  • Drowsiness
  • Memory problems
  • Changes in menstrual cycle
  • Confusion
  • Weight loss
  • Chills and fever
  • Nausea
  • Decrease in sexual drive
  • Difficulty or painful urination
  • Skin rash or itching

Uses of Topiramate

What is it prescribed for?

  • Seizures
  • Lennox-Gastaut Syndrome
  • Migraine Headache
Read More
Concerns

Commonly asked questions

  • Onset of action
    The amount of time required for Topiramate to show its action is not clinically established.
  • Duration of effect
    Topiramate may remain in your body for approximately 5 days.
  • Safe with alcohol?
    Consumption of alcohol is not recommended during treatment with Topiramate due to the increased risk of side effects such as dizziness, difficulty in concentration, impaired judgment, etc.
  • Is it habit forming?
    No habit-forming tendency has been reported for Topiramate.
  • Usage in pregnancy?
    Topiramate is unsafe for use during pregnancy as it may harm your developing foetus. Hence, consult your doctor if you are pregnant.
  • Usage while breast-feeding?
    Topiramate may pass into the breastmilk. Hence it is not recommended for use while breastfeeding unless necessary. Consult your doctor if you are breastfeeding.

Allergy

Avoid taking Topiramate if you are allergic to this medicine. Seek medical attention if you experience symptoms such as a skin rash, hives (itchy, painful eruptions that sting), swelling (especially of your face, lips, tongue, etc.), breathing difficulty, etc.
Warnings for special population

Pregnancy

Topiramate is unsafe for use during pregnancy as it may harm your developing foetus. Hence, consult your doctor if you are pregnant.

Breast-feeding

Topiramate may pass into the breastmilk. Hence it is not recommended for use while breastfeeding unless necessary. Consult your doctor if you are breastfeeding.
General warnings

Withdrawal symptoms

Avoid abrupt discontinuation of Topiramate may cause increased seizure frequency. Therefore, the treatment should be withdrawn gradually over a period under the close supervision of your doctor. Do not stop the use of this medicine without consulting your doctor.

Suicidal tendency

Topiramate should be used with caution as it may increase the risk of depression and suicidal thoughts or behaviour. Consult your doctor immediately if you experience changes in mood and behaviour or develop thoughts of self-harm while taking this medicine.

Driving or operating machines

Topiramate may cause dizziness, drowsiness, or blurred vision. Avoid performing activities that require mental alertness, such as driving vehicles or operating machines, if you experience such symptoms.

Metabolic acidosis

Topiramate should be used with caution if you have metabolic acidosis (a condition that occurs when the body produces too much acid or when the kidneys are unable to remove enough acid from the body) due to the increased risk of worsening of your condition.

Missed Dose

Take the missed dose of Topiramate as soon as you remember. If it is time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.

Overdose

Never take more than the prescribed dose. Seek emergency medical treatment in case of an overdose of Topiramate.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

Topiramate, when coadministered with other CNS depressants including alcoholic beverages, may lead to excessive somnolence and other forms of nervous system depression.

Instructions

Consumption of alcohol is not recommended during treatment with Topiramate due to the increased risk of side effects such as dizziness, difficulty in concentration, impaired judgment, etc.
Interaction with Medicine

Amitriptyline

Clozapine

Escitalopram

Metformin

Atropine

Buprenorphine

Clonidine

Amoxapine

Codeine

Cetirizine

Clobazam

Baclofen

Asenapine

Aripiprazole

Perampanel

Oxazepam

Disease interactions

Blood disorders

Bone marrow suppression is a condition in which there is decreased production of blood cells in your bone marrow (a spongy substance present at the centre of your bones). Topiramate may cause a decrease in blood cell counts. Hence, it should be used with caution in bone marrow suppression. Your doctor may suggest blood tests to monitor your blood cell counts during treatment with this medicine.

Severe liver impairment

Topiramate should be used with extreme caution if you have liver problems as it may further worsen your condition. Your doctor may suggest tests to periodically monitor your liver function and recommend dose adjustments or replacements with a suitable alternative based on your clinical condition.

Kidney dysfunction

Topiramate is filtered by the kidneys and removed from the body via urine. Hence, it should be used with caution if you have kidney problems. An impaired kidney function may cause an accumulation of this medicine in the body and increase the risk of undesired effects. Your doctor may adjust the dose of this medicine based on your condition.

Angle Closure Glaucoma

Angle Closure Glaucoma is a condition that develops when the drainage angle (a structure inside the eye that allows the draining of the fluid from the eye) gets blocked. This may cause an increase in fluid pressure inside the eyes and lead to vision loss. Topiramate may cause angle-closure glaucoma with symptoms such as decreased clearness of vision, eye pain, increased pressure within the eyes, etc. Hence, Topiramate should be used with extreme caution if you have conditions that may cause increased fluid pressure within the eyes, as this medicine may further worsen your condition.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Topiramate with or without food. Do not break, chew, or crush the tablet in your mouth. Swallow as a whole with plenty of water. Follow all the instructions given on the prescription label/packing insert. Do not take more or less than the recommended dose of Topiramate. Take this medicine for the recommended duration. Do not discontinue this medication abruptly without consulting your doctor. Take Topiramate at the same time every day for the ease of remembering. Consult your doctor immediately if you experience any changes in mood and behaviour or thoughts of self-harm. Keep this medicine away from the reach of children and pets. Ensure that the unused or expired medicine is disposed of properly.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

May cause sleepiness

How it works
Topiramate works by increasing the release of inhibitory chemicals which decreases the excitability of the brain cells.
Legal Status

Approved

Approved

Approved

Approved

Classification

Category

Carbonic anhydrase inhibitor anticonvulsants, Antimigraine agents

Schedule

Schedule H

Medicines.org.uk. 2022. Topamax 200mg Tablets - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 2 February 2022].

https://www.medicines.org.uk/emc/medicine/31475>

Drugs, H., 2022. Topiramate: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 2 February 2022].

https://medlineplus.gov/druginfo/meds/a697012.html>

Dailymed.nlm.nih.gov. 2022. DailyMed - TOPIRAMATE capsule, coated pellets. [online] Available at: < [Accessed 2 February 2022].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e4886adf-199d-4b19-a4ef-75f8f94cb54e>

Medicines.org.uk. 2022. [online] Available at: < [Accessed 2 February 2022].

https://www.medicines.org.uk/emc/files/pil.1442.pdf>

Accessdata.fda.gov. 2022. [online] Available at: < [Accessed 2 February 2022].

https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/020505s029,020844s024pi.pdf>

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Information on this page was last updated on 15 Feb 2022

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