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Generic Name: Topiramate Tablets (toe-PYRE-a-mate)
Brand Name: Topamax

Topamax is used for:

Treating certain kinds of seizures in patients 2 years of age or older. It is also prescribed to prevent migraine headache in adults.

Topamax is a carbonic anhydrase inhibitor. It works by controlling nerve impulses in the brain.

Do NOT use Topamax if:

  • you are allergic to any ingredient in Topamax
  • you are taking other carbonic anhydrase inhibitors (eg, acetazolamide)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Topamax :

Some medical conditions may interact with Topamax . Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, plan to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have liver or kidney problems, kidney stones, or regularly consume alcohol
  • if you have diarrhea, a respiratory tract disease, or you are scheduled for surgery
  • if you have status epilepticus (continuous seizure activity or a series of seizures without a full return to consciousness)
  • if you are on a diet that increases the amount of ketones in your blood and results in fruity-smelling breath

Some MEDICINES MAY INTERACT with Topamax . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Carbamazepine or hydantoins (eg, phenytoin) because the effectiveness of Topamax may be decreased
  • Amitriptyline, carbamazepine, hydantoins (eg, phenytoin), or metformin because the actions and side effects of these medicines may be increased
  • Risperidone because its effectiveness may be decreased by Topamax

This may not be a complete list of all interactions that may occur. Ask your health care provider if Topamax may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Topamax :

Use Topamax as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Topamax may be taken with or without food.
  • Drink plenty of fluids while taking Topamax to prevent kidney stones from forming.
  • Swallow Topamax whole. Do not crush, break, or chew before swallowing.
  • Suddenly stopping Topamax may cause seizures to occur more often. Stopping therapy should be gradual.
  • If you miss a dose of Topamax , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use Topamax .

Important safety information:

  • Topamax may cause dizziness, drowsiness, confusion, difficulty concentrating, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Topamax . Using Topamax alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Topamax . Topamax will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
  • Topamax may reduce sweating, which could raise body temperature, especially in children. The risk of this serious side effect is greater in hot weather and/or during vigorous exercise. Drink plenty of fluids and dress lightly while in hot climates or when exercising. Check carefully for signs of decreased sweating. If this occurs, promptly seek cooler or air-conditioned shelter and/or stop exercising. Seek immediate medical attention if your body temperature is above normal, or if you have mental or mood changes, headache, or dizziness.
  • Additional monitoring of your dose or condition may be needed if you are taking other medicines that reduce sweating. These medicines include anticholinergics (eg, benztropine), amitriptyline, haloperidol, or carbonic anhydrase inhibitors (eg, acetazolamide).
  • Topamax may result in a change in the acidity (pH) of your blood. If you experience loss of appetite, changes in breathing, tiredness, or change in heart rhythm, contact your health care provider.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are taking Topamax .
  • Topamax may decrease the effectiveness of your birth control pill. To prevent pregnancy, be sure to use an additional form of birth control while using Topamax .
  • Diabetic patients - Topamax may alter blood sugar levels in patients taking metformin. Check your blood sugars more frequently and contact your doctor for dose changes.
  • LAB TESTS, such as serum bicarbonate, may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.
  • Topamax is not recommended for use in CHILDREN under the age of 2 years; safety and effectiveness in this age group have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Topamax during pregnancy. Topamax is excreted in breast milk. If you are or will be breast-feeding, check with your doctor to discuss the risks to your baby.

Possible side effects of Topamax :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations (numbness or tingling, decreased sensitivity); abnormal walking; agitation or aggression; appetite loss; back pain; breast pain; change in speech; clumsiness; coordination decreased; confusion; constipation; decreased hearing; decreased sweating; depression; diarrhea; difficulty with concentration or attention; dizziness; drowsiness; dry mouth; fatigue; flu-like symptoms; hot flushes; injury; indigestion; infection; itching; leg pain;menstrual disorder;mood swings; muscle pain or contractions; nausea; nervousness or anxiety; runny nose; saliva increased; sex drive decreased; sinus swelling; skin disorder; stomach pain or ache; strange taste; sore throat; thinking problems; thirst; tremor; unstable emotions; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine; blurred vision or sudden worsening of vision; chest pain; difficulty concentrating; fast, deep breathing; feeling of moving slowly; increased body temperature; irregular heartbeat; loss of consciousness; memory problems; painful/red eyes;prostate problems;severe stomach pain; significant weight loss; speech problems; stupor; unexplained fever; unusual eye movements; unusual tiredness; urinary incontinence; urinary tract infection.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (, or emergency room immediately. Symptoms may include abnormal coordination; agitation; blurred vision; convulsions; depression; dizziness; drowsiness; lethargy; mental impairment; speech disturbance; stomach pain; stupor.

Proper storage of Topamax :

Store Topamax at room temperature (59 to 86 degrees F; 15 to 30 degrees C), away from heat, light, and moisture. Do not store in the bathroom. Keep Topamax out of the reach of children and away from pets.

General information:

  • If you have any questions about Topamax , please talk with your doctor, pharmacist, or other health care provider.
  • Topamax is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Topamax . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: November 1, 2006
Database Edition
Copyright © 2006 Wolters Kluwer Health, Inc.

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