Skip to main content

How long does it take for Topamax to start working?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on June 18, 2025.

Official Answer by Drugs.com

Your doctor will prescribe a lower dose of Topamax at the beginning. Your dose will be slowly increased to the amount needed to control your seizures or migraine and to help limit side effects.

Your dose is not usually increased more than once per week. Your dose will be gradually increased until you have an effective response, reach a maximum allowed dose, or have intolerable side effects.

Related: Topamax dosage (in more detail)

Take Topamax every day as directed by your doctor. Do not change your dose without speaking to your doctor first. Before stopping, it is recommended that the dose be reduced gradually.

When taken twice a day, the medicine is usually taken in the morning and evening. At the beginning of treatment for some uses, your dose may be taken only at night for a short while.

Why is Topamax prescribed?

Topamax (topiramate), classified as an anticonvulsant medicine, is an oral medication taken alone or with other medicines to control certain types of seizures due to epilepsy and for the prevention of migraine headaches.

It is approved by the FDA:

Topamax may cause drowsiness, dizziness, blurred vision or impair your thinking and reaction time. Avoid driving or operating machinery until you know how this medicine will affect you.

You can take Topamax with or without food. The tablets are bitter so do not break, crush or split them. Do not drink alcohol while taking Topamax as it may worsen side effects like drowsiness or dizziness. Drink plenty of fluids during the day to help prevent kidney stones.

Learn more: View Topamax side effects, warnings and drug interactions (in more detail)

This is not all the information you need to know about Topamax (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 Topamax and discuss this information and any questions you have with your doctor or other health care provider.

Related questions

References

Read next

Best time to take Topamax (topiramate): morning or night?

Topamax (topiramate) is approved to be taken alone or with other medicines to control certain types of seizures and for the prevention of migraine headaches. When taken twice a day, the medicine is usually taken in the morning and evening. When increasing your dose at the start of treatment, your dose may be taken only at night for one week. Follow your healthcare providers directions exactly. Topamax can cause drowsiness and dizziness, so do not drive or perform other hazardous activities until you are aware of its effects.

Continue reading

Topamax for migraines: how long should you take it?

You can usually stay on Topamax (topiramate) to help prevent your migraine headaches as long as the treatment is needed and remains safe for you. You and your doctor will decide how long you stay on treatment. This will be based on how well it is working for you and any side effects you may experience. Continue reading

Can you drink alcohol while taking Topamax (topiramate)?

It is not recommended to drink alcohol while taking Topamax (topiramate). Alcohol can increase side effects such as dizziness, drowsiness, and impaired coordination. In some cases, topiramate is also used off-label to help treat alcohol use disorder.

Continue reading

See also:

Related medical questions

Drug information

Related support groups