Topamax (topiramate) is a seizure medication, also called an anticonvulsant. Topamax is used alone or in combination with other medications to treat seizures in adults and children who are at least 2 years old. Topamax is also used to prevent migraine headaches in adults.

Why have I been prescribed Topamax?

Topamax (Topirimate) belongs to a group of medicines called “antiepileptic medicines.” It is used:

How does it work?

  • It is not know exactly how it works but it is thought to increase the amount of a certain chemical in the brain which calms the brain down and stops the nerves firing inappropriately.

When and how do I take it?

Always take Topamax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

  • Topamax tablets are to be swallowed whole. Avoid chewing the tablets as they may leave a bitter taste.
  • Topamax hard capsules may be swallowed whole or may be opened and sprinkled on a teaspoon of soft food of any type. Examples are applesauce, custard, ice cream, porridge, pudding or yogurt. Drink fluids right after to make sure all of the food and medicine mixture is swallowed.
  • Hold the hard capsule upright so that you can read the word “TOP”.
  • Carefully twist off the clear portion of the capsule. You may find it best to do this over the small portion of food onto which you will be pouring the sprinkles.
  • Sprinkle all of the capsule‟s contents onto a spoonful of soft food, taking care to see that the entire prescribed dosage is sprinkled onto the food.
  • Be sure to swallow the entire spoonful of the sprinkle/food mixture immediately. Avoid chewing. Drink fluids immediately in order to make sure all of the mixture is swallowed.
  • Never store any medicine and food mixture for use at a later time.
  • Topamax can be taken before, during or after a meal. Drink plenty of fluids during the day to prevent kidney stones while taking Topamax.

What’s the dose?

  • 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.

Could it interact with other tablets?

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, vitamins and herbal 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.

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

What are the possible risks or side-effects?

Like all medicines, Topamax can cause side effects, although not everybody gets them.

Very common side effects include:

Common side effects include:

  • Changes in mood or behaviour, including anger, nervousness, sadness
  • Weight gain
  • Decrease or loss of appetite
  • Reduced number of red blood cells
  • Changes in thinking and alertness, including confusion, problems with concentration, memory or slowness in thinking
  • Slurred speech
  • Clumsiness or problems with walking
  • Involuntary shaking in the arms, hands or legs
  • Reduced sense of touch or sensation
  • Involuntary movement of the eyes
  • Distorted sense of taste
  • Visual disturbance, blurred vision, double vision
  • Ringing sound in the ears
  • Ear pain
  • Shortness of breath
  • Nose bleeds
  • Vomiting
  • Constipation
  • Stomach pain
  • Indigestion
  • Dry mouth
  • Tingling or numbness of the mouth
  • Kidney stones
  • Frequent urination
  • Painful urination
  • Hair loss
  • Skin rash and/or itchy skin
  • Joint pain
  • Muscle spasms, muscle twitching or muscle weakness
  • Chest pain
  • Fever
  • Loss of strength
  • General feeling of feeling unwell
  • Allergic reaction

Can I drink alcohol while taking it?

  • You should avoid drinking alcohol when taking Topamax.

What if I’m pregnant/breastfeeding?

  • Talk to your doctor before using Topamax if you are pregnant, trying to become pregnant or breast-feeding. Your doctor will decide if you can take Topamax. As with other antiepilepsy 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.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note:
We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.


Health Reference: Migraine, Epilepsy