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Generic name: topiramate [ toe-PIR-a-mate ]
Brand names: Eprontia, Qudexy XR Sprinkle, Topamax, Topamax Sprinkle, Topiramate ER (Eqv-Qudexy XR), ... show all 8 brands
Dosage forms: oral capsule (15 mg; 25 mg), oral capsule, extended release (100 mg; 150 mg; 200 mg; 25 mg; 50 mg), ... show all 4 dosage forms
Drug class: Carbonic anhydrase inhibitor anticonvulsants

Medically reviewed by on Apr 16, 2024. Written by Cerner Multum.

What is topiramate?

Topiramate is used alone or with other medications to treat certain types of seizures in adults and children at least 2 years old. Some brand forms of topiramate extended-release capsule are used only in adults and children who are at least 6 years old.

Topiramate is also used to prevent migraine headaches in adults and children who are at least 12 years old.

Topiramate may also be used for purposes not listed in this medication guide.

Topiramate side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Topiramate may cause serious side effects. Call your doctor at once if you have:

Topiramate can affect growth in children. Your child's height and weight may be checked often. Tell your doctor if your child is not growing at a normal rate while using topiramate long-term.

Common side effects of topiramate may include:

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.


Topiramate may cause vision problems that can lead to permanent vision loss. Call your doctor right away if you have any eye pain or redness or any changes in your vision.

Topiramate may cause decreased sweating and increased body temperature. Children and people exposed to hot weather may be more likely to have this side effect.

Some people have thoughts about suicide while taking topiramate. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Topiramate can decrease bone mineral density, which may increase the risk of developing osteoporosis when the medicine is used in children over long periods of time.

Before taking this medicine

You should not use topiramate if you are allergic to it.

Tell your doctor if you have or have ever had:

Taking topiramate may increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children. Ask your doctor about your individual risk.

Some people have thoughts about suicide while taking topiramate. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Tell your doctor if you are pregnant or plan to become pregnant. Your doctor should determine whether you need topiramate. Taking topiramate during pregnancy may cause birth defects or medical problems in the baby. There may be other medications that are safer to use during pregnancy.

You must use effective birth control while using topiramate. Topiramate can make certain birth control less effective. Ask your doctor about other birth control options.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of topiramate on the baby.

Ask a doctor if it is safe to breastfeed while using topiramate.

How should I take topiramate?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take topiramate with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Drink plenty of liquids while you are taking topiramate to help prevent kidney stones.

Certain brand forms can only be swallowed whole. If you are unable to swallow a tablet or capsule whole, read and carefully follow the Instructions for Use provided to you on how to prepare and take topiramate. Ask a doctor or pharmacist if you do not understand these instructions.

Doses are based on weight in children and teenagers. Your child's dose may change if the child gains or loses weight.

You may need blood tests before and during treatment with topiramate, and your next dose may be changed based on the results. Your doctor will need to check your progress on a regular basis. Keep all follow-up visits to your doctor.

You should not stop using topiramate suddenly. Follow your doctor's instructions about tapering your dose.

Call your doctor if your symptoms do not improve, or if they get worse.

Store tightly closed at room temperature, away from moisture, heat, and light. Do not allow the liquid medicine to freeze. Throw away any unused liquid medicine 90 days after opening the bottle.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 6 hours. Do not take two doses at one time.

For extended-release capsule: Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal.

What should I avoid while taking topiramate?

Do not drink alcohol. Dangerous side effects could occur. Certain brand forms of topiramate must be taken 6 hours before or after drinking alcohol.

Avoid becoming overheated or dehydrated in hot weather. Topiramate can increase body temperature and decrease sweating, leading to life-threatening dehydration (especially in children).

Avoid the use of a ketogenic or "ketosis" diet (high in fat, low in carbohydrates) while you are taking topiramate.

Avoid driving or hazardous activity until you know how topiramate will affect you. This medicine may cause dizziness, blurred vision, balance or memory problems and this may impair your reactions or cause falls, accidents, or severe injuries.

What other drugs will affect topiramate?

Using topiramate with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may affect topiramate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Popular FAQ

Yes, topiramate (Topamax) has been shown to cause weight loss when used for both seizure control and migraine prevention. Topiramate by itself is not specifically approved by the FDA for weight loss, but is used in an "off-label" fashion for this condition. Qsymia, an extended-release medicine that contains phentermine and topiramate, is FDA approved for weight loss, along with diet and exercise. Continue reading

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 reading

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

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

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

Trokendi (topiramate) XR can lead to weight loss when used for prevention of migraine headaches or seizures, but it is not approved as a weight loss medicine. Loss of appetite and other digestive issues, which may contribute to weight loss, have been reported in topiramate studies. Continue reading

Topamax and Trokendi XR and are both approved by the FDA for seizure control in certain forms of epilepsy and for migraine headache prevention, but there are differences between these drugs, including approved ages for use, dosage forms, and dosing schedules. Continue reading

Topiramate is a prescription medication, taken alone or with other medicines to control certain types of seizures due to epilepsy. It is also used for the prevention of migraine headaches. Continue reading

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Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.