What is topiramate?
Topiramate is a seizure medicine, also called an anticonvulsant. Topiramate is used to treat seizures in adults and children who are at least 2 years old. Trokendi XR is for use in adults and children who are at least 6 years old.
Extended-release topiramate has a higher minimum age (at least 10 years old) when used as the child's only seizure medicine.
The Topamax and Qudexy brands of this medicine are also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. Topamax will only prevent migraine headaches or reduce the number of attacks. It will not treat a headache that has already begun.
Topiramate may also be used for purposes not listed in this medication guide.
Topiramate may cause vision problems that can be permanent if not treated quickly. Call your doctor right away if you have a sudden decrease in vision.
Topiramate can decrease sweating and may cause life-threatening dehydration (especially in children). Avoid becoming overheated or dehydrated. Tell your doctor if you have decreased sweating, high fever, and hot dry skin.
Do not take Trokendi XR within 6 hours of drinking alcohol.
Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
Do not stop using topiramate suddenly or you could have increased seizures.
Before taking this medicine
You should not use topiramate if you are allergic to it. Do not take Trokendi XR within 6 hours before or 6 hours after drinking alcohol. You should not use extended-release topiramate if you have metabolic acidosis (high levels of acid in your blood) and are also taking metformin for diabetes.
To make sure topiramate is safe for you, tell your doctor if you have ever had:
glaucoma or other eye problems;
diabetes, or metabolic acidosis;
kidney disease, kidney stones, or dialysis;
severe breathing problems;
mood problems, depression, or suicidal thoughts or actions;
a growth disorder;
if you are sick with diarrhea.
Topiramate can increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children or harm to an unborn baby. You may need blood tests to make sure you do not have metabolic acidosis, especially if you are pregnant.
Some people have thoughts about suicide while taking an anticonvulsant. Your doctor will need to check your progress at regular visits while you are using topiramate. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Do not start or stop taking topiramate during pregnancy without your doctor's advice. Topiramate may increase the risk of low birth weight and cleft lip and/or cleft palate in a newborn. There may be other seizure medicine that can be more safely used during pregnancy. Tell your doctor right away if you become pregnant.
Topiramate can pass into breast milk, but effects on the nursing baby are not known. Tell your doctor if you are breast-feeding.
How should I take topiramate?
Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Topiramate can be taken with or without food.
Drink plenty of liquids while you are taking topiramate, to prevent kidney stones or an electrolyte imbalance.
Do not crush, chew, or break a topiramate tablet. Swallow it whole. The Trokendi XR extended-release capsule must be swallowed whole. Do not break or open.
The Qudexy XR and Topamax Sprinkle Capsule can be swallowed whole. Or you may open the capsule and sprinkle the medicine into a spoonful of applesauce or other soft food. Swallow right away without chewing. Do not save the mixture for later use.
Carefully follow the swallowing instructions for your medicine.
While using topiramate, you may need frequent blood tests. If you need surgery, tell the surgeon ahead of time that you are using topiramate. Any medical care provider who treats you should know that you take seizure medication.
Do not stop using topiramate suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.
Call your doctor if your seizures get worse or you have them more often while taking topiramate.
Store at cool room temperature away from moisture, light, and high heat. Keep the bottle tightly closed when not in use.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if you are more than 6 hours late in taking it. Wait until your next scheduled dose. Do not take extra medicine to make up the missed dose.
Call your doctor for instructions if you miss two or more doses.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include drowsiness, agitation, depression, double vision, thinking problems, problems with speech or coordination, fainting, and seizure (convulsions).
What should I avoid while taking topiramate?
Do not drink alcohol. Dangerous side effects or increased seizures may occur.
Avoid becoming overheated or dehydrated in hot weather. Topiramate can decrease sweating and increase body temperature, leading to life-threatening dehydration (especially in children).
Ketogenic or "ketosis" diets that are high in fat and low in carbohydrates can increase the risk of kidney stones. Avoid the use of such diets while you are taking topiramate.
Topiramate may cause blurred vision or impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you.
Also avoid activities that could be dangerous if you have an unexpected seizure, such as swimming or climbing in high places.
Topiramate side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening mood 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), depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
vision problems, eye pain or redness, sudden vision loss (can be permanent if not treated quickly);
confusion, problems with thinking or memory, trouble concentrating, problems with speech;
signs of a kidney stone--severe pain in your side or lower back, painful or difficult urination;
signs of too much acid in your blood--irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or
signs of too much ammonia in your blood--vomiting, unexplained weakness, feeling like you might pass out.
Common side effects may include:
fever, weight loss;
numbness or tingling in your arms and legs;
flushing (warmth, redness, or tingly feeling);
headache, dizziness, drowsiness, tired feeling, slow reactions;
mood problems, feeling nervous;
changes in your sense of taste.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect topiramate?
Taking topiramate with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, opioid pain medication, muscle relaxer, or medicine for anxiety or depression.
Tell your doctor about all your current medicines and any you start or stop using, especially:
birth control pills;
glaucoma medication; or
This list is not complete. Other drugs may interact with topiramate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
More about topiramate
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Images
- Drug Interactions
- Compare Alternatives
- Support Group
- Pricing & Coupons
- En Español
- 887 Reviews – Add your own review/rating
- Drug class: carbonic anhydrase inhibitor anticonvulsants
- Topiramate Extended-Release Capsules
- Topiramate Extended-Release Sprinkle Capsules
- Topiramate Tablets
- Topiramate Sprinkle Capsules
- Topiramate (Advanced Reading)
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about topiramate.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 15.01.
Date modified: March 06, 2018
Last reviewed: January 15, 2018