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TOPAMAX 50MG TABLETS

Active substance(s): TOPIRAMATE

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PACKAGE LEAFLET: INFORMATION FOR THE USER
Topamax® 50mg Tablets
(topiramate)
This product is available as the above but will be referred to as
Topamax throughout the remainder of this leaflet.

Other medicines you should discuss with your doctor or
pharmacist include other antiepileptic medicines, risperidone,
lithium, hydrochlorothiazide, metformin, pioglitazone, glyburide,
amitriptyline, propranolol, diltiazem, venlafaxine, flunarazine,
St. John’s wort (Hypericum perforatum) (a herbal preparation used
to treat depression).

This product is available in multiple strengths and other strengths
will be referred to throughout this leaflet.

If you are not sure if any of the above applies to you, talk to your
doctor or pharmacist before using Topamax.

Read all of this leaflet carefully before you start taking this
medicine because it contains important information for you.
 Keep this leaflet. You may need to read it again
 If you have any further questions, ask your doctor or
pharmacist
 This medicine has been prescribed for you only. Do not pass it
on to others. It may harm them, even if their signs of illness
are the same as yours
 If you get any side effects, talk to your doctor or pharmacist.
This includes any possible side effects not listed in this leaflet.
See section 4.

Topamax with food and drink
You can take Topamax with or without food.
Drink plenty of fluids during the day to prevent kidney stones while
taking Topamax. You should avoid drinking alcohol when taking
Topamax.

What is in this leaflet
1. What Topamax is and what it is used for
2. What you need to know before you take Topamax
3. How to take Topamax
4. Possible side effects
5. How to store Topamax
6. Contents of the pack and other information
1. What Topamax is and what it is used for
Topamax belongs to a group of medicines called “antiepileptic
medicines.” It is used:
 alone to treat seizures in adults and children over age 6
 with other medicines to treat seizures in adults and children
aged 2 years and above
 to prevent migraine headaches in adults
2. What you need to know before you take Topamax
Do not take Topamax
 if you are allergic to topiramate or any of the other ingredients
of this medicine (listed in section 6)
 for migraine prevention if you are pregnant, or you are able to
become pregnant but you are not using effective
contraception (see section ‘pregnancy and breast-feeding’ for
further information)
If you are not sure if the above applies to you, talk to your doctor
or pharmacist before using Topamax.
Warnings and precautions
Talk to your doctor or pharmacist before taking Topamax if you:
 have kidney problems, especially kidney stones, or are
getting kidney dialysis
 have a history of blood and body fluid abnormality (metabolic
acidosis)
 have liver problems
 have eye problems, especially glaucoma
 have a growth problem
 are on a high fat diet (ketogenic diet)
 are pregnant or could become pregnant (see section
‘pregnancy and breast-feeding’ for further information)

Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant
or are planning to have a baby, ask your doctor for advice before
taking this medicine.
Your doctor will discuss use of contraceptives with you, as well as
discussing whether Topamax is suitable for you. As with other anti
-epileptic medicines, there is a risk of harm to the unborn child if
Topamax is used during pregnancy. Make sure you are very clear
about the risks and the benefits of using Topamax for epilepsy
during pregnancy.
You should not take Topamax for migraine prevention if you are
pregnant or you are able to become pregnant and you are not
using effective contraception.
Mothers who breast-feed while taking Topamax must tell the
doctor as soon as possible if the baby experiences anything
unusual.
Driving and using machines
Dizziness, tiredness and vision problems may occur during
treatment with Topamax. Do not drive or use any tools or
machines without talking to your doctor first.
Topamax contains lactose
If you have been told by your doctor that you have an intolerance
to some sugars, contact your doctor before taking this medicinal
product.
3. How to take Topamax
Always take this medicine exactly as your doctor has told you.
Check with your doctor or pharmacist if you are not sure.
 Your doctor will usually start you on a low dose of Topamax
and slowly increase your dose until the best dose is found for
you
 Topamax tablets are to be swallowed whole. Avoid chewing
the tablets as they may leave a bitter taste
 Topamax can be taken before, during, or after a meal. Drink
plenty of fluids during the day to prevent kidney stones while
taking Topamax
If you take more Topamax than you should
 See a doctor right away. Take the medicine pack with you
 You may feel sleepy, tired, or less alert; lack coordination;
have difficulty speaking or concentrating, have double or
blurred vision; feel dizzy due to low blood pressure; feel
depressed or agitated; or have abdominal pain, or seizures
(fits)

If you are not sure if any of the above applies to you, talk to your
doctor or pharmacist before using Topamax.

Overdose can happen if you are taking other medicines together
with Topamax.

It is important that you do not stop taking your medicine without
first consulting your doctor.

If you forget to take Topamax
 If you forget to take a dose, take it as soon as you remember
it. However, if it is almost time for your next dose, skip the
missed dose and continue as usual. If you miss two or more
doses, contact your doctor
 Do not take a double dose (two doses at the same time) to
make up for a forgotten dose

You should also talk to your doctor before taking any medicine
containing topiramate that is given to you as an alternative to
Topamax.
You may lose weight if you use Topamax so your weight should
be checked regularly when using this medicine. If you are losing
too much weight or a child using this medicine is not gaining
enough weight, you should consult your doctor.
A small number of people being treated with antiepileptic
medicines such as Topamax have had thoughts of harming or
killing themselves.
If at any time you have these thoughts, immediately contact your
doctor.
Other medicines and Topamax
Tell your doctor or pharmacist if you are taking, have recently
taken or might take any other medicines. Topamax and certain
other medicines can affect each other. Sometimes the dose of
some of your other medicines or Topamax will have to be
adjusted.
Especially, tell your doctor or pharmacist if you are taking:
 other medicines that impair or decrease your thinking,
concentration, or muscle coordination (e.g., central nervous
system depressant medicines such as muscle relaxants and
sedatives)
 birth control pills. Topamax may make your birth control pills
less effective
Tell your doctor if your menstrual bleeding changes while you are
taking birth control pills and Topamax.
Keep a list of all the medicines you take.
Show this list to your doctor and pharmacist before you start a
new medicine.

If you stop taking Topamax
Do not stop taking this medicine unless told to do so by your
doctor. Your symptoms may return. If your doctor decides to stop
this medication, your dose may be decreased gradually over a few
days.
If you have any further questions on the use of this product, ask
your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although
not everybody gets them.
Tell your doctor, or seek medical attention immediately if you
have the following side effects:
Very common (may affect more than 1 in 10 people)
 Depression (new or worse)
Common (may affect up to 1 in 10 people)
 Seizures (fits)
 Anxiety, irritability, changes in mood, confusion, disorientation
 Problems with concentration, slowness of thinking, loss of
memory, problems with memory (new onset, sudden change
or increased severity)
 Kidney stone, frequent or painful urination

Uncommon (may affect up to 1 in 100 people)
 Increased acid level in the blood (may cause troubled
breathing including shortness of breath, loss of appetite,
nausea, vomiting, excessive tiredness, and fast or uneven
heart beats)
 Decreased or loss of sweating (particularly in young children
who are exposed to high temperatures)
 Having thoughts of serious self-harm, trying to cause serious
self-harm
 Loss of part of the field of vision
Rare (may affect up to 1 in 1,000 people)
 Glaucoma – blockage of fluid in eye causing increased
pressure in the eye, pain, or decreased vision
Other side effects include the following, if they get serious,
please tell your doctor or pharmacist:
Very common (may affect more than 1 in 10 people)
 Stuffy, runny nose or sore throat
 Tingling, pain and/or numbness of various body parts
 Sleepiness, tiredness
 Dizziness
 Nausea, diarrhoea
 Weight loss
Common (may affect up to 1 in 10 people)
 Anaemia (low blood count)
 Allergic reaction (such as skin rash, redness, itching, facial
swelling, hives)
 Loss of appetite, decreased appetite
 Aggression, agitation, anger, abnormal behaviour
 Difficulty falling or staying asleep
 Problems with speech or speech disorder, slurred speech
 Clumsiness or lack of coordination, feeling of unsteadiness
when walking
 Decreased ability to complete routine tasks
 Decreased, loss of, or no sense of taste
 Involuntary trembling or shaking; rapid, uncontrollable
movements of the eyes
 Visual disturbance, such as double vision, blurred vision,
decreased vision, difficulty focusing
 Sensation of spinning (vertigo), ringing in the ears, ear pain
 Shortness of breath
 Cough
 Nose bleeds
 Fever, not feeling well, weakness
 Vomiting, constipation, abdominal pain or discomfort,
indigestion, stomach or intestinal infection
 Dry mouth
 Hair loss
 Itching
 Joint pain or swelling, muscle spasms or twitching, muscle
aches or weakness, chest pain
 Weight gain
Uncommon (may affect up to 1 in 100 people)
 Decrease in platelets (blood cells that help stop bleeding),
decrease in white blood cells that help to protect you against
infection, decrease in potassium level in the blood
 Increase in liver enzymes, increase in eosinophils (a type of
white blood cell) in the blood
 Swollen glands in the neck, armpit, or groin
 Increased appetite
 Elevated mood
 Hearing, seeing, or feeling things that are not there, severe
mental disorder (psychosis)
 Showing and/or feeling no emotion, unusual suspiciousness,
panic attack
 Problems with reading, speech disorder, problems with
handwriting
 Restlessness, hyperactivity
 Slowed thinking, decreased wakefulness or alertness
 Reduced or slow body movements, involuntary abnormal or
repetitive muscle movements
 Fainting
 Abnormal sense of touch; impaired sense of touch
 Impaired, distorted, or no sense of smell
 Unusual feeling or sensation that may precede a migraine or a
certain type of seizure
 Dry eye, sensitivity of the eyes to light, eyelid twitching, watery
eyes
 Decreased or loss of hearing, loss of hearing in one ear
 Slow or irregular heartbeat, feeling your heart beating in your
chest
 Low blood pressure, low blood pressure upon standing
(consequently, some people taking Topamax may feel faint,
dizzy, or may pass out when they stand up or sit up suddenly)
 Flushing, feeling warm
 Pancreatitis (inflammation of the pancreas)
 Excessive passing of gas or wind, heartburn, abdominal
fullness or bloating
 Bleeding gums, increased saliva, drooling, breath odour
 Excessive intake of fluids, thirst
 Skin discolouration
 Muscle stiffness, pain in side
 Blood in urine, incontinence (lack of control) of urine, urgent
desire to urinate, flank or kidney pain
 Difficulty getting or keeping an erection, sexual dysfunction
 Flu-like symptoms
 Cold fingers and toes
 Feeling drunk
 Learning disability

Rare (may affect up to 1 in 1,000 people)
 Abnormally elevated mood
 Loss of consciousness
 Blindness in one eye, temporary blindness, night blindness
 Lazy eye
 Swelling in and around the eyes
 Numbness, tingling and colour change (white, blue then red) in
fingers and toes when exposed to the cold
 Inflammation of the liver, liver failure
 Stevens Johnson syndrome, a potentially life threatening
condition that may present with sores in multiple mucosal sites
(such as the mouth, nose, and eyes), a skin rash, and
blistering
 Abnormal skin odour
 Discomfort in your arms or legs
 Kidney disorder
Not known (frequency cannot be estimated from the available
data)
 Maculopathy is a disease of the macula, the small spot in the
retina where vision is keenest. You should call your doctor if
you notice a change or decrease in your vision.
 Toxic epidermal necrosis, a life-threatening condition related
to, yet more severe than, Stevens-Johnson syndrome,
characterized by widespread blistering and sloughing of the
outer layers of the skin (see rare side effects)
Children
The side effects in children are generally similar to those seen in
adults, but the following side effects may be more common in
children than adults:
 Problems with concentration
 Increased acid level in the blood
 Having thoughts of serious self-harm
 Tiredness
 Decreased or increased appetite
 Aggression, abnormal behaviour
 Difficulty falling or staying asleep
 Feeling of unsteadiness when walking
 Not feeling well
 Decrease in potassium level in the blood
 Showing and/or feeling no emotion
 Watery eyes
 Slow or irregular heartbeat
Other side effects that may occur in children are:
Common (may affect up to 1 in 10 people)
 Sensation of spinning (vertigo)
 Vomiting
 Fever
Uncommon (may affect up to 1 in 100 people)
 Increase in eosinophils (a type of white blood cell) in the blood
 Hyperactivity
 Feeling warm
 Learning disability
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaflet.
In the UK, you can also report side effects directly via the Yellow
Card Scheme at: www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on
the safety of this medicine.
5. How to store Topamax
 KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
 Do not use Topamax after the expiry date which is on the
blister/bottle/carton. The expiry date refers to the last day of
that month.
 Do not store above 25°C. Store the tablets in the original
package to protect from moisture.
 Do not throw away any medicines via wastewater or
household waste. Ask your pharmacist how to throw away
medicines you no longer use. These measures will help
protect the environment.
6.

Contents of the pack and other information

What Topamax contains
 Each tablet contains 50mg of the active substance
Topiramate.
 The other ingredients of Topamax are: lactose monohydrate,
maize starch pregelatinised, microcrystalline cellulose, sodium
starch glycolate (type A), magnesium state, opadry yellow,
carnauba wax, hypromellose, macrogol, polysorbate 80,
titanium dioxide E171 and yellow iron oxide E172.
What Topamax looks like and contents of the pack
Your tablets are round, light yellow tablets marked with ‘50’ on one
side and ‘TOP’ on the other side. They come in packs of 60.
Manufacturer
Manufactured by Janssen Cilag S.p.A., 04010 Borgo S.Michele,
Latina Italy.
Or
Janssen Pharmaceutica NV, Turnhoutseweg 30, B-2340 Beerse,
Belgium. Procured from within the EU and repackaged by the
Product Licence holder: G-Pharma Ltd, Salford, M50 2PU.
PL 16369/1609

POM

Leaflet revision and issue date:
18/01/2016
‘Topamax’ is a registered trademark of Janssen-Cilag.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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