Topiramate

Sounds like 'toe-PEER-uh-mate'

Easy-to-read medicine information about topiramate– what it is, how to take it safely and possible side effects.

Type of medicine Also called
  • Anti-epileptic medication (to prevent seizures or fits)
  • Topamax®
  • Arrow-Topiramate®
  • Topiramate Actavis

What is topiramate?

Topiramate is mainly used to prevent and control some types of epileptic seizures such as generalised seizures and partial epilepsy. It belongs to a group of medications called anti-epileptic medication. It is also used to prevent migraine headaches and reduce how often you get them. It will not treat a migraine once it has started. Topiramate is available as tablets and capsules. 

Dose

  • The dose of topiramate will be different for different people.
  • The usual dose is 50 to 100 mg twice daily. 
  • Your doctor will start you on a low dose, and increase it slowly over a few weeks.
  • Always take your topiramate exactly as your doctor has told you. The pharmacy label will tell you how much topiramate to take, how often to take it and any special instructions.

How to take topiramate

  • Swallow your topiramate tablets whole with a full glass of water.
  • The capsules can be swallowed whole with a glass of water or opened carefully and the beads sprinkled onto a small amount of soft food such as a teaspoon of porridge, yoghurt or custard. Do not chew the capsules or beads. 
  • Take topiramate at the same times each day, in the morning and night. If the label says to take it once a day, then it's best taken at bedtime.
  • You can take topiramate with or after food.
  • Limit or avoid drinking alcohol while you are taking topiramate. It can increase your chance of side effects such as drowsiness.
  • If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time (4 hours or less) until your next dose, just take the next dose at the right time. Do not take double the dose.
  • Keep taking topiramate regularly every day. Do not stop taking topiramate suddenly; speak to your doctor or nurse before stopping.

Special instructions

Topiramate can cause an increase in your body temperature and reduced sweating, especially during hot weather and exercise. This can put you at increased risk of getting kidney stones. To prevent this, it is important to drink plenty of water and keep hydrated while you are taking topiramate. Tell your doctor immediately or ring HealthLine 0800 611 116 if you get sudden pain in the stomach (tummy) area, difficulty passing urine (pee) or blood in your urine.    

Possible side effects

Like all medicines, topiramate can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Feeling sleepy, drowsy or tired
  • Feeling dizzy
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Limit or avoid alcohol.
  • Tell your doctor if troublesome.
  • Stuffy, runny nose and sore throat
  • Tingling in the arms and legs
  • This usually wears off after a short time.
  • Tell your doctor if troublesome.
  • Changes in moods
  • Having low mood, feeling depressed, or feelings of hurting yourself.
  • Tell your doctor immediately or ring HealthLine 0800 611 116 
  • Problems with your eyesight such as blurry vision, sudden loss of sight or eye pain. 
  • Tell your doctor immediately or ring HealthLine 0800 611 116 

Interactions

Topiramate may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist if you are taking topiramate. Topiramate can affect birth control pills. Talk to your doctor about using other types of contraception.  

Learn more

Medsafe Consumer Information Sheets Topamax

References

  1. Prescribing issues associated with anticonvulsant medications for epilepsy. BPAC, November 2009
  2. Topiramate - titrate and hydrate SafeRx,November 2016
  3. Topiramate New Zealand Formulary
  4. Topamax New Zealand data sheet  
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Jul 2017