Does topiramate cause hair loss?
- Yes, topiramate (Topamax) has been shown to cause hair loss (alopecia) in studies, but it is not a common side effect.
- Hair loss has been reported in 1% to 4% of children ages 6 to 16 years of age, and in 3% to 4% of patients older than 16 years of age.
- Higher daily doses (400 mg/day) of topiramate were associated with greater rates of hair loss than lower doses (50 mg/day) in both age groups.
Hair loss with topiramate has also been reported in case reports in the scientific literature.
- In one report, a 16-year old girl experienced hair loss after two months of using topiramate as an adjunctive treatment for epilepsy. The hair loss was reversed after treatment was stopped, but occurred again when topiramate treatment was restarted.
- In another case, an 18-year old patient being treated with topiramate 50 mg/day for migraines developed hair loss after 3 months. The medicine was tapered and discontinued and hair loss stopped. Two weeks after reintroduction of the topiramate hair loss developed again. Once again after treatment discontinuation, the hair loss ceased.
Hair loss is a common side effect reported with other antiepileptic agents such as valproic acid and carbamazepine, and may cause cosmetic, social and compliance consequences for patients.
What has the FDA approved topiramate to treat?
Topiramate is used to help prevent seizures, either used alone or with other seizure medicines, in certain forms of epilepsy in patients 2 years of age and older. It is approved for migraine prevention in patients 12 years and older.
Common brand names for topiramate or extended-release topiramate include:
Generic topiramate is available as an oral tablet, capsule or extended-release capsule in various strengths and may be less expensive than brand names. If preferred, ask your doctor if a generic formulation is possible for your condition.
Related questions
- Can you stop taking Topamax suddenly?
- When's the best time of day to take Topamax?
- How long do you stay on Topamax for migraines?
Which side effects can I expect with topiramate?
The most common side effects (≥10% and more frequent than placebo) reported in epilepsy studies in both adults and children include:
- paresthesia (unusual feeling of the skin, such as burning, numbness, tingling, or “pin-and-needles”)
- anorexia (loss of appetite)
- weight loss
- speech disorders
- fatigue and somnolence (drowsiness)
- dizziness
- nervousness
- mental slowing, slowed reflexes
- vision changes
- fever
In migraine studies in adults and children, side effects (incidence ≥5% and more frequent than placebo) were:
- paresthesia
- anorexia, weight loss, nausea
- trouble with memory
- altered taste
- diarrhea
- hypoesthesia (a decrease in sensations such as the feeling of touch or temperature)
- stomach pain
- respiratory tract infection
Related: View topiramate side effects, warnings and drug interactions (in more detail)
This is not all the information you need to know about topiramate for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full patient information for topiramate and discuss this information and any questions you have with your doctor or other health care provider.
References
- Topamax (topiramate) Product Information. Revised 6/2020. Janssen Pharmaceuticals, Inc. Titusville, NJ. Accessed March 22, 2021 at https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/020505s061,020844s052lbl.pdf
- Chuang Y, Chang W, Chen I, et al: Topiramate-Induced Hair Loss: Case Report. Dermatol Psychosom 2002;3:183-184.
- Ghafoor I, Hosseini H. Hair Loss Following The Topiramate Treatment. JBUMS. 2017; 19(2):71-74
- Trokendi XR (topiramate extended-release). Product information. Supernus Pharmaceuticals, Inc., Rockville, Maryland. Revised Nov. 2020. Accessed March 22, 2021 at https://www.trokendixr.com/assets/TrokendiXRPrescribingInformation.pdf
Read next
How long does it take for Topamax to start working?
It may take 8 to 12 weeks for you to see the full effect of Topamax on your migraine headaches. In clinical studies, some people had fewer headaches after 4 weeks of treatment. In the treatment of epilepsy, Topamax is also started slowly and the dose is increased over a 6-week period. Continue reading
How long does Topamax stay in your system?
Topamax stays in your system for approximately 4 to 5 days after the last dose, but this may vary depending on personal factors, such as your age, weight, dosage, and what other medications you currently take. This estimate is based on the half-life of Topamax which is about 21 hours and experts agree that it takes up to 5 half-lives for a drug without active metabolites to be completely removed from the body. A drug’s half-life is the time it takes for 50% of that drug to be removed from the body. Topamax does have some metabolites, but these are not considered active and only make up about 5% of an administered dose. This means it takes 84 to 105 hours for Topamax to leave your body. Continue reading
Is Topamax a controlled substance?
Topamax is not classified as a controlled substance under the U.S. Controlled Substances Act (CSA). Topamax is an anticonvulsant (seizure) medication, but is also prescribed for other conditions such as prevention of migraine. It may causes side effects like confusion, drowsiness, dizziness, or blurred vision. Know how Topamax may affect you before driving or performing other hazardous activities. Continue reading
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