Topiramate (
Topamax®) is a prescription medication used to treat various conditions related to the nervous system. Specific topiramate uses include:
Topiramate is made by Ortho-McNeil Neurologics.
How Does Topiramate Work?
It is not entirely clear how topiramate works for
epilepsy or
migraines. An epileptic
seizure occurs as the result of abnormal electrical signals in the brain. Topiramate slows those signals, helping to prevent
seizures. The medication also works similarly for
migraine headaches. It is thought that migraines may be triggered by nerve cells in the brain that are too easily excited. Topiramate helps calm the nerve cells, working to prevent a migraine from ever starting.
In studies, topiramate increased the time until the next seizure and decreased the number of seizures. In one study of adults with epilepsy, approximately 75 percent of people taking topiramate 400 mg per day were seizure-free for at least one year.
In one study of topiramate for preventing migraines, topiramate 200 mg per day reduced the average number of migraines from 5.5 per month to 3.1 per month.
When and How to Take Topiramate
Some general considerations for when and how to take topiramate include:
- Topiramate comes in tablets or "sprinkle" capsules. It is taken by mouth, usually twice a day.
- Topiramate sprinkle capsules can be opened and the contents sprinkled on a spoonful of soft food and swallowed (not chewed) immediately.
- It does not matter if you take topiramate with or without food.
- Topiramate should be taken at the same times each day to maintain an even level of the drug in your blood.
- For topiramate to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.
The dose of topiramate that your healthcare provider recommends will vary depending on a number of factors, including:
- Your age
- The medical condition being treated
- Other medical conditions you may have
- Other medications you may currently be taking.
As is always the case, do not adjust your topiramate dose unless your healthcare provider specifically instructs you to do so.
Side Effects of Topiramate
As with any medicine, there are possible side effects with topiramate. However, not everyone who takes the medication will experience side effects. In fact, most people tolerate the drug well. When topiramate side effects do occur, in most cases they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects of topiramate include, but are not limited to:
- Unusual sensations, such as burning or tingling (paresthesias)
- Dizziness
- Fatigue
- Drowsiness
- Mental and physical slowing or delays
- Nervousness
- Upper respiratory infection (such as the common cold)
- Coordination problems
- Weight loss (see Topamax Weight Loss).
(Click Topiramate Side Effects to learn about specific side effects of topiramate, including some of the more serious side effects that you should report to your healthcare provider.)
You can also read about other possible topiramate side effects by clicking on the following links:
Topiramate Drug Interactions
Topiramate can potentially interact with several other medicines.
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking topiramate if you have:
- Kidney disease, such as kidney failure (renal failure)
- Liver disease, such as liver failure or cirrhosis
- Kidney stones
- Glaucoma
- Severe respiratory conditions
- Severe diarrhea
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all other medicines you may be taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
People who take too much topiramate may have overdose symptoms that could include:
- Seizures
- Speech problems
- Blurred vision
- Thinking problems
- Lethargy
- Poor coordination
- Low blood pressure (hypotension)
- Abdominal pain (or stomach pain)
- Agitation
- Dizziness
- Depression.
If you happen to overdose on topiramate, seek medical attention immediately.
Topiramate: Storage Methods
Topiramate should be stored at room temperature, away from moisture and heat. The tablets and capsules should be stored in an airtight container.
Keep topiramate and all medications out of the reach of children
Topiramate: What Should I Do If I Miss a Dose?
If you do not take your topiramate as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose of topiramate.
Topiramate tablets are available in four strengths:
- Topiramate 25 mg tablets
- Topiramate 50 mg tablets
- Topiramate 100 mg tablets
- Topiramate 200 mg tablets.
Topiramate sprinkle capsules are available in two strengths:
- Topiramate 15 mg sprinkle capsules
- Topiramate 25 mg sprinkle capsules.
Currently, there is no generic topiramate licensed for sale.
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