Best time to take Topamax (topiramate): morning or night?
Key Takeaways
Topamax (topiramate) is taken alone or with other medicines to control certain types of seizures due to epilepsy 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 beginning of treatment, your dose may be taken only at night for a short while.
Topamax is classified as an anticonvulsant (seizure) medication, but is prescribed for other conditions, too, such as migraine. It is available as a generic option which may save you money. Copay cards from the manufacturer are also available.
When you first start treatment, you will start with a low dose of Topamax and slowly increase 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.
Topamax can cause drowsiness, dizziness and slowed reactions, so use caution when using this medication. Do not drive, operate machinery or engage in other potentially harmful activities until you know how you will respond to the medicine. Topamax can slow your thinking and motor skills, and may affect your vision.
Topamax used alone for seizures (partial-onset seizures and primary generalized tonic-clonic seizures):
- Adults and children 10 years of age and older usually start taking Topamax twice a day, in the morning and in the evening. You start with a low dose of Topamax and slowly increase to the amount needed to control your seizures.
- In children 2 to 9 years of age, treatment may begin with one dose given in at night. After one week, the doctor may increase the dose and give as two doses per day based upon how well the medicine is tolerated and the results. Doses in this age group are based on weight.
Topamax used with other medicines for seizures (partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome):
- Adults 17 years of age and older usually start taking Topamax once or twice a day at a lower dose, and their dose is slowly increased to reach the amount needed to control your seizures.
- In children 2 to 16 years of age treatment should begin with one dose given at night for the first week. After one week, the doctor may then increase the dose and give as two doses per day based upon how well the medicine works for you and is tolerated. Doses in this age group are based on weight.
Topamax used to prevent migraine headaches:
- Adults and adolescents 12 years of age and older initially take Topamax as one dose at night for one week. After one week, the dose can be slowly increased and given as two doses per day, in the morning and evening.
- Your doctor can determine your dose based upon how well the medicine works for you and how well you tolerate it.
Related: Topamax dosage (in more detail)
Should I take Topamax with food?
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. Drink plenty of fluids like water while taking Topamax.
Learn more: Topamax side effects (in more detail)
Other brand names for topiramate include Trokendi XR (a long-acting form), Topamax Sprinkle, and Qudexy XR (also long-acting).
This is not all the information you need to know about Topamax (topiramate) for safe and effective use and does not replace your doctor's directions. Review the full product information here, and discuss this information and any questions you have with your doctor or other health care provider.
References
- Topamax (topiramate). Product Labeling. Revised March 24, 2025. Janssen Pharmaceuticals, Inc., Titusville, NJ. Accessed Aug 18, 2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=21628112-0c47-11df-95b3-498d55d89593
Read next
How effective is Topamax (topiramate) for weight loss?
Topiramate (Topamax) has been shown to cause weight loss in both adults and children when used for seizure control and migraine prevention. Topiramate use by itself is not specifically approved by the FDA for weight loss, but may be used"off-label" by some healthcare providers. Qsymia, an extended-release medicine that contains phentermine and topiramate is FDA approved for weight loss, along with diet and exercise.
Continue reading
Can you stop taking Topamax suddenly?
Talk to your doctor first if you want to stop taking Topamax (topiramate), even if you do not have epilepsy. You should not stop taking Topamax suddenly unless your doctor has told you to stop. Stopping suddenly may increase the risk of seizures or other withdrawal side effects. If you have epilepsy and you stop taking Topamax suddenly, you may have seizures that do not stop. Continue reading
Does Topamax (topiramate) cause hair loss?
Yes, topiramate has been shown to cause hair loss in studies, but it is not a common side effect. Hair loss (also called alopecia) 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.
Continue readingSee also:
Related medical questions
- Topamax for migraines: how long should you take it?
- How long does it take for Topamax to start working?
- Can you drink alcohol while taking Topamax (topiramate)?
- How long does Topamax stay in your system?
- Is Topamax (topiramate) a controlled substance?
- Are Topamax and Trokendi XR the same thing?
- What not to take with topiramate?
Drug information
Related support groups
- Topamax (102 questions, 702 members)
- Topiramate (48 questions, 257 members)