Health Library

Topiramate (By mouth)

Topiramate (toe-PIR-a-mate)

Treats and prevents seizures. Also prevents migraine headaches.

Brand Name(s):

Eprontia, Qudexy XR, Topamax, Trokendi XR

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Long Acting Capsule, Liquid, Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Capsule or extended-release capsule: Do not crush or chew the capsule. Swallow whole or open the capsule and sprinkle the contents into a small amount (1 teaspoon) of soft food (including applesauce). Swallow the mixture right away without chewing. Do not save for later use.
• Tablet: Swallow whole. Do not break, crush, or chew it. It has a very bitter taste.
• Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you miss a dose of Topamax® or Eprontia® and it is within 6 hours until your next regular dose, skip the missed dose and take your next dose at the regular time. If you miss more than 1 dose of Topamax® or Eprontia®, call your doctor for instructions.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Throw away any unused oral liquid 60 days after first opening.

Drugs and Foods to Avoid:

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

• Some medicines can affect how topiramate works. Tell your doctor if you are using any of the following:
  • Acetazolamide, amitriptyline, dichloralphenazone, dichlorphenamide, digoxin, hydrochlorothiazide, lithium, zonisamide
  • Birth control pills
  • Oral diabetes medicine (including metformin, pioglitazone)
  • Other medicines to treat seizures (including carbamazepine, phenytoin, valproic acid)
• Do not drink alcohol with Eprontia®, Qudexy™ XR, or Topamax®. Do not drink alcohol for 6 hours before and 6 hours after you take the Trokendi XR® capsule.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, glaucoma, lung or breathing problems, bone problems (including osteoporosis, osteomalacia, osteopenia), or a history of depression or mood disorders. Tell your doctor if you are on a ketogenic diet (high in fat and low in carbohydrates).
• This medicine may cause the following problems:
  • Eye pain or vision changes, including glaucoma
  • Changes in body temperature
  • Changes in mood or behavior, including thoughts of suicide
  • Metabolic acidosis (too much acid in the blood)
  • Decreased bone density
  • Slow growth in children
  • Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis
  • Kidney stones
• This medicine may make you dizzy, drowsy, or tired. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Blistering, peeling, red skin rash
• Bloody or cloudy urine, painful urination, sudden lower back or stomach pain
• Bone fractures, pain, tenderness, or aching, pain in the back, ribs, arms, or legs, decrease in height
• Changes in vision, eye pain
• Confusion, problems with walking, clumsiness, dizziness, trouble talking, concentrating, or remembering
• Feeling agitated, depressed, nervous, or irritable, thoughts of hurting yourself or others, unusual mood or behavior
• Fever, decreased sweating
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Rapid, deep breathing, fast or uneven heartbeat
• Slow growth in children
• Unusual drowsiness, tiredness, or weakness

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

• Change in taste
• Diarrhea, nausea, vomiting
• Stuffy or runny nose
• Loss of appetite, weight loss

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

Last Updated: 9/6/2024