Topiramate Side Effects
Some side effects of topiramate 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
Get emergency medical help if you have any of these signs of an allergic reaction while taking topiramate: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have a serious side effect such as:
sudden vision loss, pain around or behind your eyes;
dry mouth, increased thirst, drowsiness, decreased sweating, increased body temperature, and hot, dry skin,
confusion, slowed thinking, memory problems, trouble concentrating, problems with speech or balance;
vomiting, loss of appetite, tired feeling, irregular heartbeats, feeling like you might pass out; or
severe pain in your side or lower back, painful or difficult urination.
Less serious side effects of topiramate may include:
mild dizziness, feeling nervous;
numbness or tingly feeling;
diarrhea, 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. Tell your doctor about any unusual or bothersome side effect.
For Healthcare Professionals
Applies to topiramate: oral capsule, 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 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 topiramate resources
- topiramate Advanced Consumer (Micromedex) - Includes Dosage Information
- topiramate MedFacts Consumer Leaflet (Wolters Kluwer)
- Topiramate Prescribing Information (FDA)
- Topiramate Professional Patient Advice (Wolters Kluwer)
- Topiramate Monograph (AHFS DI)
- Topamax Prescribing Information (FDA)
- Topamax Consumer Overview
- Topiragen Prescribing Information (FDA)
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