Topamax (Topiramate)

Do's

• Take Topamax orally with or without food as directed by your healthcare provider, usually twice daily. Swallow the tablets whole to prevent a bitter taste. Drink plenty of liquids while taking this medication unless your healthcare provider instructs otherwise, to prevent kidney stones from forming.
• Dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight. Your healthcare provider will gradually increase your dose to reduce the risk of side effects. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication.
• For some conditions, you may start treatment with Topamax once daily at bedtime and slowly increase your dose to twice a day.
• Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Do not stop taking this medication without consulting your healthcare provider, as some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.

Common Side Effects:

• Weight loss
• Cognitive side effects, including confusion, trouble concentrating, fatigue, and memory problems
• Stomach problems, such as belly pain, nausea, indigestion, diarrhea, and constipation
• Ocular (eye-related) side effects, including abnormal vision, double vision, and blurred vision

Serious Side Effects:

• High ammonia in the blood, which can affect mental activities, alertness, cause tiredness, or vomiting
• Effects on thinking and alertness: confusion, problems with concentration, attention, memory, or speech, depression or mood problems, tiredness, and sleepiness
• Liver problems

This is not a complete list of side effects, and others may occur. If you experience any side effects while taking Topamax, consult your healthcare provider for medical advice. 

Topamax may cause vision problems that can be permanent if not treated quickly. Seek immediate medical attention if you experience blurred vision or periorbital pain while taking Topamax.

Overdoses of Topamax have resulted in severe metabolic acidosis, which can have serious clinical consequences. If an overdose occurs, appropriate supportive treatment should be administered until clinical toxicity has been diminished or resolved.

Individuals with liver problems, such as cirrhosis or hepatitis, may have a raised risk for a side effect called hyperammonemia (a high level of ammonia in the blood) with Topamax. Extra blood tests may be necessary during treatment for individuals with liver problems.

If you have had an allergic reaction to Topamax or any of its ingredients, you should not take Topamax. Discuss alternative medication options with your healthcare provider in such cases.

Topamax can harm a developing fetus and may pass into breast milk, potentially causing side effects in a breastfed child. Discuss the risks and benefits of using Topamax during pregnancy and breastfeeding with a healthcare provider.