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What is the most important information I should know about
topiramate?
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Seek immediate medical attention if you experience blurred
vision, changes in vision, or pain in or around the eyes during
treatment with topiramate. These may be early signs of a serious side
effect. |
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Do not stop taking topiramate without first talking to your
doctor, even if your symptoms have improved. It is important to continue
taking topiramate to prevent seizures from recurring. |
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Carry or wear a medical identification tag to let others
know that you are taking topiramate in the case of an emergency. |
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Use caution when driving, operating machinery, or performing
other hazardous activities. Topiramate may cause dizziness or drowsiness.
If you experience dizziness or drowsiness, avoid these activities. |
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Alcohol should be avoided while taking topiramate. Alcohol
may cause increased sedation or drowsiness. It may also increase the
risk of having a seizure. |
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Unless otherwise directed by your doctor, drink several
extra glasses of fluid each day during treatment with topiramate to
minimize the risk of side effects such as kidney stone formation and
metabolic acidosis (a decrease in a certain electrolyte in the body).
Additional fluid may be necessary during hot weather, vigorous exercise,
and illness (e.g., fever, vomiting, diarrhea). |
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Decreased sweating and high body temperature have been
associated with the use of topiramate. These side effects may be
dangerous. Avoid becoming overheated in hot weather and during vigorous
exercise, monitor sweating, and drink plenty of fluid to maintain
hydration. If sweating is decreased or body temperature is elevated,
contact your doctor. |
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The exact way that topiramate works is unknown. However, it
is believed that topiramate alters the chemical impulses in the brain
that cause seizures. |
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Topiramate is used with other medications to control
seizures. Topiramate is also used to prevent migraine headaches. |
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Topiramate may also be used for purposes other than those
listed in this medication guide. |
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What should I discuss with my healthcare provider before taking
topiramate?
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Before taking topiramate, tell your doctor if you |
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have kidney disease or a history of kidney stones; |
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have lung or respiratory disease such as asthma, emphysema,
or bronchitis; or |
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You may not be able to take topiramate, or you may require a
dosage adjustment or special monitoring during treatment |
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Topiramate is in the FDA pregnancy category C. This means
that it is not known whether topiramate will be harmful to an unborn
baby. Do not take this medication without first talking to your doctor
if you are pregnant or if you could become pregnant during treatment. |
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It is not known whether topiramate passes into breast milk.
Do not take topiramate without first talking to your doctor if you are
breast-feeding a baby. |
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How should I take topiramate?
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Take topiramate exactly as directed by your doctor. If you
do not understand these directions, ask your pharmacist, nurse, or
doctor to explain them to you. |
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Take each dose of topiramate with a full glass of water. |
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The tablets should be swallowed whole. Due to their bitter
taste, the tablets should not be broken. |
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The capsules may be swallowed whole or opened to facilitate
swallowing. If the capsules are opened, the entire contents of the
capsule should be sprinkled onto a small amount (teaspoon) of soft food
(e.g., applesauce, custard, ice cream, oatmeal, pudding, yogurt). This
drug/ food mixture should be swallowed immediately, without chewing. The
mixture should not be stored for future use. If the mixture is combined
in a small container, add some water to the container after the dose has
been taken, and drink the water to ensure the whole dose has been taken. |
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Topiramate can be taken with or without food. |
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It is important to take topiramate regularly to get the most
benefit. |
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Carry or wear a medical identification tag to let others
know that you are taking this medicine in the case of an emergency. |
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• |
Do not stop taking topiramate without first talking to your
doctor, even if your symptoms have improved. It is important to continue
taking topiramate to prevent seizures from recurring. |
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• |
Unless otherwise directed by your doctor, drink several
extra glasses of fluid each day during treatment with topiramate to
minimize the risk of side effects such as kidney stone formation and
metabolic acidosis (a decrease in a certain electrolyte in the body).
Additional fluid may be necessary during hot weather, vigorous exercise,
and illness (e.g., fever, vomiting, diarrhea). |
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Your doctor may want you to have blood tests or other
medical evaluations during treatment with topiramate to monitor progress
and side effects. |
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Store topiramate at room temperature away from moisture and
heat. |
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What happens if I miss a dose?
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Take the missed dose as soon as you remember. However, if it
is almost time for the next dose, skip the dose you missed and take only
the next regularly scheduled dose. Do not take a double dose of
this medication. |
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What happens if I overdose?
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Seek emergency medical treatment if an overdose is suspected. |
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Symptoms of a topiramate overdose are not known but may
include severe drowsiness, poor coordination, tremor, confusion,
difficulty speaking, and nausea. |
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What should I avoid while taking topiramate?
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Use caution when driving, operating machinery, or performing
other hazardous activities. Topiramate may cause dizziness or drowsiness.
If you experience dizziness or drowsiness, avoid these activities. |
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• |
Alcohol should be avoided while taking topiramate. Alcohol
may cause increased sedation or drowsiness. It may also increase the
risk of having a seizure. |
|
• |
Unless otherwise directed by your doctor, drink several
extra glasses of fluid each day during treatment with topiramate to
minimize the risk of side effects such as kidney stone formation and
metabolic acidosis (a decrease in a certain electrolyte in the body).
Additional fluid may be necessary during hot weather, vigorous exercise,
and illness (e.g., fever, vomiting, diarrhea). |
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Ketogenic diets (high protein, very low carbohydrate diets
that may induce ketosis) may increase the risk of kidney stone formation
and should be avoided during treatment with topiramate. |
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Decreased sweating and high body temperature have been
associated with the use of topiramate. These side effects may be
dangerous. Avoid becoming overheated in hot weather and during vigorous
exercise, monitor sweating, and drink plenty of fluid to maintain
hydration. If sweating is decreased or body temperature is elevated,
contact your doctor. |
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Tell your doctor and dentist that you are taking topiramate
before having any type of surgery. |
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What are the possible side effects of topiramate?
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Seek immediate medical attention if you experience blurred
vision, changes in vision, or pain in or around the eyes during
treatment with topiramate. These may be early signs of a serious side
effect. |
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If you experience any of the following serious side effects,
stop taking topiramate and seek emergency medical attention or contact
your doctor immediately: |
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an allergic reaction (difficulty breathing; closing of your
throat; swelling of your lips, tongue, or face; or hives); |
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metabolic acidosis (a high acidity of the blood that may be
detected by blood tests). Symptoms of metabolic acidosis include
increased rate of breathing, decreased appetite, and irregular
heartbeats; |
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fever or increased body temperature; or |
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side or low back pain, or painful or difficult urination (may
indicate kidney stones). |
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Other, less serious side effects may be more likely to occur.
Continue to take topiramate and talk to your doctor if you experience |
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dizziness, poor coordination, sluggishness, or drowsiness; |
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irregular back-and-forth movements of the eyes; |
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nausea, decreased appetite, or weight loss; |
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tremor, numbness, or tingling; |
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confusion, difficulty concentrating or decreased memory; |
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speech or language difficulties; or |
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changes in behavior, depression, nervousness, or agitation. |
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Side effects other than those listed here may also occur. Talk to
your doctor about any side effect that seems unusual or that is
especially bothersome. |
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What other drugs will affect topiramate?
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Before taking topiramate, tell your doctor if you are taking any of
the following medicines: |
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another seizure medication such as valproic acid (Depakote, Depakene),
carbamazepine (Tegretol, Carbatrol, Epitol), phenytoin (Dilantin), and
others; |
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a carbonic anhydrase inhibitor such as acetazolamide (Diamox),
methazolamide (Neptazane), or dichlorphenamide (Daranide); |
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metformin (Glucophage, Fortamet); or |
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digoxin (Lanoxin, Lanoxicaps). |
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You may not be able to take topiramate, or you may require a dosage
adjustment or special monitoring during treatment if you are taking any
of the drugs listed above. |
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Topiramate may decrease the effectiveness of certain birth control
pills. Talk to your doctor about other birth control options to prevent
unintended pregnancy. |
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Topiramate may increase the effects of other drugs that cause
drowsiness, including antidepressants, alcohol, antihistamines, pain
relievers, sedative (sleep aids), anxiety medicines, and muscle
relaxants. Dangerous sedation, dizziness, or drowsiness may occur if
topiramate is taken with any of these medications. |
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Drugs other than those listed here may also interact with topiramate.
Talk to your doctor and pharmacist before taking any prescription or
over-the-counter medicines, including vitamins, minerals, and herbal
products. |
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Where can I get more information?
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Your pharmacist has additional information about topiramate written
for health professionals that you may read. |
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Remember, keep this and all other medicines out of the reach of
children, never share your medicines with others, and use this
medication only for the indication prescribed. |
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Every effort has been made to ensure that the information provided
by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete,
but no guarantee is made to that effect. Drug information contained
herein may be time sensitive. Multum information has been compiled for
use by healthcare practitioners and consumers in the United States and
therefore Multum does not warrant that uses outside of the United States
are appropriate, unless specifically indicated otherwise. Multum's drug
information does not endorse drugs, diagnose patients or recommend
therapy. Multum's drug information is an informational resource designed
to assist licensed healthcare practitioners in caring for their patients
and/ or to serve consumers viewing this service as a supplement to, and
not a substitute for, the expertise, skill, knowledge and judgment of
healthcare practitioners. The absence of a warning for a given drug or
drug combination in no way should be construed to indicate that the drug
or drug combination is safe, effective or appropriate for any given
patient. Multum does not assume any responsibility for any aspect of
healthcare administered with the aid of information Multum provides. The
information contained herein is not intended to cover all possible uses,
directions, precautions, warnings, drug interactions, allergic reactions,
or adverse effects. If you have questions about the drugs you are taking,
check with your doctor, nurse or pharmacist. |
Copyright 1996-2004 Cerner Multum, Inc. Version: 7.01. Revision date: 11/
9/ 04. |