Topamax (Topiramate) Oral: Uses, Side Effects, Dosages

What is the most important information I should know about Topamax?

• Before taking Topamax (topiramate), tell your doctor if you are pregnant, have impaired kidney function, or are taking another anticonvulsant.

What is Topamax?

• Topamax (topiramate) is a prescription medication used to treat epilepsy and migraine headaches.
• It's also used off-label to treat a wide range of mood and eating disorders and to aid in substance abuse therapy.

How does Topamax work?

• Topamax's mechanism of action is unclear.
• It's believed to block sodium channels that deliver electrical impulses to nerve, muscle, brain, and other excitable cells, enhancing the activity of GABA, a chemical messenger (neurotransmitter).

What strengths and forms is Topamax available in?

• Topamax is available in capsule and tablet formulations.
• The tablet is offered in 25-, 50-, 100-, and 200-milligram (mg) formulations.
• The capsule is available in 15 mg and 25 mg.

What are the approved uses for Topamax?

• Migraine prevention in adults and adolescents 12 and older
• Partial-onset seizure treatment in adults and children two and older
• Primary generalized tonic-clonic seizure treatment in adults and children two and older
• Topamax can also be combined with other drugs to treat partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.

What are the off-label uses for Topamax?

• Alcohol dependency
• Bipolar disorder
• Borderline personality disorder (BPD)
• Depression
• Post-traumatic stress disorder (PTSD)
• Tourette syndrome
• Weight loss (specifically to control binge-eating and purging)

How should I take Topamax?

• Your healthcare provider will typically increase your dosage gradually at the beginning of treatment to reduce the risk of side effects.
• The medication takes approximately five days to build up and reach a steady state in your system.
• Your healthcare provider will tell you how to taper down your dosage gradually if you decide together to stop using it.
• Don't stop taking it abruptly on your own; this can cause a rebound of symptoms.
• Don't stop taking topiramate without consulting your healthcare provider.

How should I store Topamax?

• Store Topamax at room temperature, out of direct light, and away from heat and moisture in a closed container.

What are the side effects of Topamax?

Common/mild side effects

• Breast pain in women
• Tremors
• Constipation
• Warmth
• Heartburn
• Increased sweating
• Redness of the face, neck, arms, or upper chest

Consult your healthcare provider if you notice any of the following:

• Aggression, anger, agitation, irritability
• Back-and-forth or rolling eye movements
• Burning or tingling sensations
• Chest pain
• Chills
• Confusion
• Decreased sexual performance or libido
• Difficulty speaking
• Drowsiness
• Dulled sensations or perception
• Fever
• Increased fatigue or weakness
• Irritated gums
• Lack of appetite
• Lack of emotion
• Lack of interest or pleasure in things you ordinarily enjoy
• Memory or concentration problems
• Menstrual issues
• Slowed thinking or movement
• Sore throat
• Stomach pain
• Trouble sleeping
• Unsteadiness or dizziness
• Vision problems
• Weight loss

What is the dosage for Topamax?

• Your provider will determine the best dosage for you based on several factors, including your weight, condition, other medications, age, and contraindications.
• Generally, this will be the lowest dosage that's likely to provide the desired results.
• Usually, you'll begin with a low dose, which your doctor will slowly raise until it reaches the optimum for your condition.

What should I do if I miss a dose of Topamax?

• If you forget to take Topamax, take it as soon as you remember, unless it's close to your next dose time. In that case, skipped the missed dose and then resume your usual dosing schedule. Don't ever take more than one dose at a time.
• If you miss more than one dose, consult your healthcare provider. You'll probably have to restart your treatment regimen.

What happens if I overdose on Topamax?

• Symptoms of a topiramate overdose include:
  • Lessened responsiveness or awareness
  • Dizziness, fainting, or lightheadedness upon standing up
  • Severe fatigue or drowsiness
  • Sluggishness
• Seek help immediately if you think you've taken too much Topamax.

What are the precautions for taking Topamax?

• Wait to see how you feel when you take Topamax before you drive, swim, use dangerous equipment, or do anything else that requires balance, good vision, or focus.
• Check with your practitioner before you take any other medicines, whether prescribed or over the counter.
• Topamax can cause you to sweat less than usual. Stop taking a hot shower or doing anything else that could increase your body temperature if you feel woozy or sick.
• Tell your doctor if you feel irritated, angry, anxious, or any other unusual way. Some people become depressed or suicidal when starting this medication.
• Avoid alcohol and recreational drugs. Combining them with Topamax can cause serious interactions.

When should I not take Topamax?

• Glaucoma
• Kidney damage
• Metabolic acidosis
• Pregnancy
• Breastfeeding

What other medications interact with Topamax?

• Certain drugs reduce or increase the availability of Topamax. Your doctor might have to adjust your dosage to compensate.
• Topamax also can reduce the efficacy of estrogen-based contraceptives, increasing the risk of pregnancy and breakthrough bleeding.

What are some similar medications to Topamax?

• A wide variety of Topamax alternatives is available; your healthcare provider can help you find one that's right for you.

How can I stay healthy while taking Topamax?

• Follow the usual guidelines for healthful eating, exercise, sleep, etc. to help Topamax do its work.
• Avoid ketogenic diets while you're taking Topamax to minimize the risk of kidney stones. Drink lots of fluids.
• Topamax can reduce the efficacy of oral contraceptives, so consider using additional methods as backup.