Topiramate (By mouth)

Introduction

Topiramate (toe-PIR-a-mate)

Helps control and prevent certain kinds of seizures. Also prevents migraine headaches in adults.

How to Store and Dispose of This Medicine

• Sprinkle Capsule: If you sprinkle the medicine over food, do not keep any of the mixture for future use.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. Your doctor may also want you to join a pregnancy registry for patients taking a seizure medicine.
• Make sure your doctor knows if you are breastfeeding, or if you have kidney disease, liver disease, bone problems (osteoporosis), eye or vision problems, glaucoma, a growth problem (children), lung or breathing problems, nerve problems, or a history of kidney stones, depression, mental problems, or metabolic acidosis (too much acid in the blood). Tell your doctor if you are on a ketogenic (high-fat, low-protein, low-carbohydrate) diet. Tell your doctor if you are having a surgery or kidney dialysis.
• Check with your doctor immediately if you have eye pain or redness, blurred vision, difficulty with reading, or any other change in vision while you are using this medicine. Your doctor may want you or your child to have your eyes checked by an eye doctor.
• This medicine may make you sweat less, causing your body temperature to go higher. Use extra care to avoid becoming overheated during exercise or hot weather while you or your child are taking this medicine. Overheating may result in a heat stroke.
• This medicine may cause some people to be confused, irritable, tired, or display other abnormal behaviors. It may also cause some people to have problems with concentrating, suicidal thoughts and tendencies, or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away.
• This medicine may cause nausea, muscle tremors, fast breathing, problems eating, fast heartbeat, restlessness, and abdominal or stomach pain. Tell your doctor right away if you or your child have any of these symptoms. This may be a sign that you or your child may be having a metabolic acidosis (too much acid in the blood).
• This medicine may cause slow growth. If your child is using this medicine, the doctor will need to keep track of your child's height and weight to make sure that your child is growing properly.
• This medicine may cause your body temperature to go down especially when taking valproic acid, which is another medicine to control seizures. You may have tiredness, weakness, confusion, and abnormal heartbeat and breathing. Tell your doctor right away if you feel any of these side effects.
• Check with your doctor right away if you or your child are having unusual drowsiness, dullness, tiredness, weakness, or feelings of sluggishness; mental depression or anxiety; nightmares or unusually vivid dreams; or vomiting. These may be symptoms of a serious condition called hyperammonemic encephalopathy.
• Check with your doctor right away if you or your child have sudden back pain, abdominal or stomach pain, pain while urinating, or bloody or dark urine. These may be symptoms of kidney stones.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Tell your doctor if your or your child's skin feels like it is burning, crawling, itching, or if you have numbness, prickling, "pins and needles", or tingling feeling after using topiramate.
• This medicine may make you dizzy, drowsy, confused, or tired. Avoid driving, using machines, climbing in high places, swimming, or doing anything else that could be dangerous if you are not alert.
• If your symptoms do not improve or if they get worse, call your doctor.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.

Brand Name(s)

Topamax, Topiragen

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using acetazolamide (Diamox®), dichlorphenamide (Daranide®), digoxin (Lanoxin®), lithium (Eskalith®, Lithobid®), metformin (Glucophage®), zonisamide (Zonegram®), or other medicines for seizures (such as carbamazepine, phenytoin, valproic acid, Depakene®, Depakote®, Dilantin®, Keppra?, or Tegretol®).
• Birth control pills may not work while you are using topiramate. To keep from getting pregnant, use another form of birth control together with the birth control pills, such as condoms, diaphragms, or contraceptive foams or jellies.
• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
• Do not drink alcohol while you are using this medicine.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

When This Medicine Should Not Be Used

How to Use This Medicine

Capsule, Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine will be used together with other seizure medicines. Keep using all of your medicines unless your doctor tells you to stop.
• You may take this medicine with or without food.
• Swallow the tablet whole. Do not break, crush, or chew it. The tablet has a very bitter taste.
• You may swallow the sprinkle capsule whole, or you may open it and pour the medicine into a small amount (teaspoonful) of soft food such as pudding, yogurt, or applesauce. To do this, hold the capsule so you can read the word "TOP." Holding the capsule over the food, gently twist off the clear part of the capsule. Sprinkle all of the medicine onto the food. Swallow all of the food with the medicine without chewing. Drink some water right away.
• Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Abdominal or stomach pain.
• Blistering, peeling, or red skin rash.
• Bloody or cloudy urine.
• Changes in mood or behavior.
• Feeling agitated, depressed, nervous, or irritable.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Problems with walking or coordination.
• Rapid, deep breathing.
• Sharp pain in your lower back.
• Sleepiness or unusual drowsiness.
• Sudden and severe stomach pain, nausea, vomiting, fever, and lightheadedness.
• Sudden pain in your eye, blurred vision, or eye redness.
• Uneven heartbeat.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Change in taste or bitter taste.
• Change in your menstrual period.
• Dizziness, or loss of muscle coordination.
• Mild skin rash.
• Nausea, vomiting, loss of appetite, or diarrhea.
• Not feeling hungry.
• Stuffy or runny nose.
• Trouble sleeping.
• Trouble with talking, concentrating, or remembering.
• Weight loss.