Topamax Side Effects
Generic name: topiramate
Note: This document contains side effect information about topiramate. Some of the dosage forms listed on this page may not apply to the brand name Topamax.
Some side effects of Topamax may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to topiramate: oral capsule, oral tablet
Along with its needed effects, topiramate (the active ingredient contained in Topamax) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking topiramate:More common
- Any vision problems, especially blurred vision, double vision, eye pain, or rapidly decreasing vision
- burning, prickling, or tingling sensations
- clumsiness or unsteadiness
- continuous, uncontrolled back-and-forth or rolling eye movements
- eye redness
- generalized slowing of mental and physical activity
- increased eye pressure
- memory problems
- menstrual changes
- menstrual pain
- speech or language problems
- trouble in concentrating or paying attention
- unusual tiredness or weakness
- Abdominal or stomach pain
- fever, chills, or sore throat
- lessening of sensations or perception
- loss of appetite
- mood or mental changes, including aggression, agitation, apathy, irritability, and mental depression
- red, irritated, or bleeding gums
- weight loss
- Blood in the urine
- decrease in sexual performance or desire
- difficult or painful urination
- eye pain
- frequent urination
- hearing loss
- loss of bladder control
- lower back or side pain
- pale skin
- red or irritated eyes
- ringing or buzzing in the ears
- skin rash
- troubled breathing
- Blistering, peeling, or loosening of the skin
- blisters in the mouth
- blisters on the trunk, scalp, or other areas
- clay-colored stools
- increased rate of breathing
- joint or muscle pain
- pain or tenderness in upper abdomen or stomach
- red skin lesions, often with a purple center
- sores, ulcers, or white spots in the mouth or on the lips
- yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur while taking topiramate:Symptoms of overdose
- Decreased awareness or responsiveness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
- muscle tremors
- rapid, deep breathing
- severe sleepiness
- stomach cramps
- sweating unusual
Some side effects of topiramate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Breast pain in women
- Back pain
- chest pain
- hot flushes
- increased sweating
- leg pain
For Healthcare Professionals
Applies to topiramate: oral capsule, oral capsule extended release, oral tablet
General side effects including fatigue, fever, and malaise have been reported to occur frequently. Oligohidrosis, pain, chest pain, and hyperthermia have also been reported.
The majority of cognitive-related adverse events were mild to moderate in severity and frequently occurred in isolation. Rapid titration rate and higher initial doses were associated with higher incidences of cognitive-related adverse events.
Nervous system side effects have been common and have included somnolence, dizziness (greater than 25%), ataxia, speech disorders, psychomotor slowing, hypokinesia, vertigo, grand mal seizures, diplopia, nystagmus, tinnitus, and paresthesias. These nervous system adverse reactions do not appear to be dose-related. Dose-related adverse effects have included fatigue (frequently), nervousness, difficulty with concentration or attention, confusion, psychomotor slowing, difficulty with concentration/attention, difficulty with memory, speech, or language problems (particularly word finding difficulties), and tremor. Headache, vertigo, sensory disturbance, and aggravated migraine have also been reported. A case has been reported of cerebrospinal fluid acidosis associated with hyperventilation that was probably caused by topiramate.
Hepatic side effects including hepatic failure (sometimes fatal) and hepatitis have been reported.
The primary treatment of cases of secondary angle closure glaucoma cause by topiramate (the active ingredient contained in Topamax) is discontinuation of the drug.
Ocular side effects including cases of secondary angle closure glaucoma characterized by ocular pain, acute myopia, abnormal accommodation, and increased intraocular pressure have been reported. Maculopathy has also been reported.
Gastrointestinal side effects include diarrhea, vomiting, pancreatitis, gastroenteritis, constipation, gastroesophageal reflux, tooth disorder, and flatulence have been reported. Tongue edema has been reported rarely.
Cardiovascular side effects including palpitations have been reported frequently. Hypertension and hypotension have been reported infrequently.
Hematologic side effects including anemia and epistaxis have been a reported frequently.
Metabolic side effects have included metabolic acidosis, dehydration, diabetes mellitus, and weight increase.
Musculoskeletal side effects including arthralgia, myalgia, and muscle weakness have been reported. A case of hemiparesis has also been reported.
Psychiatric side effects including insomnia, personality disorder, impotence, hallucination, euphoria, psychosis, decreased libido, anxiety, depression, mood problems, and suicide attempts have been reported. Two cases of panic attacks have also been reported.
Depression and mood problems were dose related.
Genitourinary side effects in the female frequently have included intermenstrual bleeding, leukorrhea, menorrhagia, vaginitis, and amenorrhea. Urinary tract infections, micturition frequency, urinary incontinence, dysuria, and renal calculus have also been reported frequently. Cases of reversible anorgasmia have also been reported. Kidney stones (1.5%) have occurred more frequently in men.
Respiratory side effects including pulmonary embolism, coughing, pneumonia, asthma, and bronchitis have been reported.
Dermatologic side effects including bullous skin reactions (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), pemphigus, acne, rash, and alopecia have been reported. Pruritus has been reported rarely.
Other side effects including taste perversion have been reported frequently. Headaches have also been reported to occur.
Renal side effects including kidney stones (1.3% to 1.5%) and renal tubular acidosis have been reported.
Hypersensitivity side effects including allergic reaction have been reported.
Immunologic side effects have been reported including infection and genital moniliasis.
More Topamax resources
- Topamax Consumer Overview
- Topamax Prescribing Information (FDA)
- Topamax Advanced Consumer (Micromedex) - Includes Dosage Information
- Topamax Monograph (AHFS DI)
- Topamax MedFacts Consumer Leaflet (Wolters Kluwer)
- Topiramate Prescribing Information (FDA)
- Topiramate Professional Patient Advice (Wolters Kluwer)
- Topiragen Prescribing Information (FDA)
- Trokendi XR Prescribing Information (FDA)
- Trokendi XR extended-release capsules MedFacts Consumer Leaflet (Wolters Kluwer)
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