Topamax

Topamax

     * Generic Name: topiramate
     * Brand Name: Topamax


     * What is topiramate?
     * What are the possible side effects of topiramate?
     * What is the most important information I should know about
       topiramate?
     * What should I discuss with my healthcare provider before taking
       topiramate?
     * How should I take topiramate?
     * What happens if I miss a dose?
     * What happens if I overdose?
     * What should I avoid while taking topiramate?
     * What other drugs will affect topiramate?
     * Where can I get more information?

What is topiramate?

   Topiramate is a seizure medicine, also called an
   anticonvulsant. Topiramate is used to treat seizures in adults and
   children who are at least 2 years old. Trokendi XR is for use in adults
   and children who are at least 6 years old.

   Extended-release topiramate has a higher minimum age (at least 10 years
   old) when used as the child's only seizure medicine.

   Some brands of topiramate are also used to prevent migraine
   headaches in adults and teenagers who are at least 12 years old. These
   medicines will only prevent migraine headaches or reduce the number of
   attacks, but will not treat a headache that has already begun.

   Topiramate may also be used for purposes not listed in this medication
   guide.

What are the possible side effects of topiramate?

   Get emergency medical help if you have signs of an allergic reaction:
   hives; difficult breathing; swelling of your face, lips, tongue, or
   throat.

   Report any new or worsening mood symptoms to your doctor, such as: mood
   or behavior changes, anxiety, panic attacks, trouble sleeping, or
   if you feel impulsive, irritable, agitated, hostile, aggressive,
   restless, hyperactive (mentally or physically), depressed, or have
   thoughts about suicide or hurting yourself.

   Call your doctor at once if you have:
     * vision problems, eye pain or redness, sudden vision loss
       (can be permanent if not treated quickly);
     * confusion, problems with thinking or memory, trouble
       concentrating, problems with speech;
     * dehydration symptoms--decreased sweating, high fever, hot and dry
       skin;
     * signs of a kidney stone--severe pain in your side or lower back,
       painful or difficult urination;
     * signs of too much acid in your blood--irregular heartbeats, feeling
       tired, loss of appetite, trouble thinking, feeling short of
       breath; or
     * signs of too much ammonia in your blood--vomiting, unexplained
       weakness, feeling like you might pass out.

   Common side effects may include:
     * fever, weight loss;
     * numbness or tingling in your arms and legs;
     * flushing (warmth, redness, or tingly feeling);
     * headache, dizziness, drowsiness, tired feeling, slow reactions;
     * mood problems, feeling nervous;
     * nausea, diarrhea, stomach pain, loss of appetite, indigestion;
     * cold symptoms such as stuffy nose, sneezing, sore
       throat; or
     * changes in your sense of taste.

   This is not a complete list of side effects and others may occur. Call
   your doctor for medical advice about side effects. You may report side
   effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about topiramate?

   Topiramate may cause vision problems that can be permanent if not
   treated quickly. Call your doctor right away if you have a sudden
   decrease in vision.

   Topiramate can decrease sweating and may cause life-threatening
   dehydration (especially in children). Avoid becoming overheated or
   dehydrated. Tell your doctor if you have decreased sweating, high
   fever, and hot dry skin.

   Do not take Trokendi XR within 6 hours of drinking alcohol.

   Some people have thoughts about suicide while taking seizure medicine.
   Stay alert to changes in your mood or symptoms. Report any new or
   worsening symptoms to your doctor.

   Do not stop using topiramate suddenly or you could have increased
   seizures.

   Topamax Patient Information including How Should I Take
   Epilepsy:Symptoms, Stages and Treatment

   Epilepsy Slideshow
   RxList

   Brain Disorders Image Collection
   RxList

   Take the Epilepsy (Seizure Disorder) Quiz

What should I discuss with my healthcare provider before taking topiramate?

   You should not use topiramate if you are allergic to it. Do not take
   Trokendi XR within 6 hours before or 6 hours after drinking alcohol.
   You should not use extended-release topiramate if you have metabolic
   acidosis (high levels of acid in your blood) and are also taking
   metformin for diabetes.

   Tell your doctor if you have ever had:
     * glaucoma or other eye problems;
     * diabetes, or metabolic acidosis;
     * kidney disease, kidney stones, or dialysis;
     * severe breathing problems;
     * mood problems, depression, or suicidal thoughts or actions;
     * liver disease;
     * soft or brittle bones (osteoporosis, osteomalacia);
     * a growth disorder; or
     * if you are sick with diarrhea.

   Topiramate can increase the level of acid in your blood (metabolic
   acidosis). This can weaken your bones, cause kidney stones, or cause
   growth problems in children or harm to an unborn baby. You may need
   blood tests to make sure you do not have metabolic acidosis, especially
   if you are pregnant.

   Some people have thoughts about suicide while taking an anticonvulsant.
   Your doctor should check your progress at regular visits. Your family
   or other caregivers should also be alert to changes in your mood or
   symptoms.

   Do not start or stop taking topiramate during pregnancy without your
   doctor's advice. Topiramate may increase the risk of low birth weight
   and cleft lip and/or cleft palate in a newborn. There may be
   other seizure medicine that can be more safely used during pregnancy.
   Tell your doctor right away if you become pregnant.

   Topiramate can make birth control pills less effective. Use a barrier
   form of birth control (such as a condom or diaphragm with
   spermicide) to prevent pregnancy while taking topiramate.

   It may not be safe to breast-feed a baby while you are using this
   medicine. Ask your doctor about any risks.

How should I take topiramate?

   Follow all directions on your prescription label and read all
   medication guides or instruction sheets. Your doctor may occasionally
   change your dose. Use the medicine exactly as directed.

   Topiramate can be taken with or without food.

   Swallow the tablet whole and do not crush, chew, or break it. The
   Trokendi XR extended-release capsule must be swallowed whole. Do not
   break or open.

   If you cannot swallow a Qudexy XR or Topamax Sprinkle Capsule whole,
   open it and sprinkle the medicine into a spoonful of applesauce or
   other soft food. Swallow the mixture right away without chewing. Do not
   save it for later use.

   Carefully follow the swallowing instructions for your medicine.

   If a child is using this medicine, tell your doctor if the child has
   any changes in weight. Topiramate doses are based on weight in
   children, and any changes may affect your child's dose.

   Drink plenty of liquids while you are taking topiramate, to prevent
   kidney stones or an electrolyte imbalance.

   You will need frequent medical tests. If you need surgery, tell the
   surgeon ahead of time that you are using topiramate. Any medical
   care provider who treats you should know that you take seizure
   medication.

   Do not stop using topiramate suddenly, even if you feel fine. Stopping
   suddenly may cause increased seizures. Follow your doctor's
   instructions about tapering your dose.

   Call your doctor if your seizures get worse or you have them more often
   while taking topiramate.

   Store at cool room temperature away from moisture, light, and high
   heat. Keep the bottle tightly closed when not in use.

   Topamax Patient Information including If I Miss a Dose
   Epilepsy:Symptoms, Stages and Treatment

   Epilepsy Slideshow
   RxList

   Brain Disorders Image Collection
   RxList

   Take the Epilepsy (Seizure Disorder) Quiz

What happens if I miss a dose?

   Take the medicine as soon as you can, but skip the missed dose if you
   are more than 6 hours late for the dose. Do not take two doses at one
   time.

   Call your doctor for instructions if you miss two or more doses.

What happens if I overdose?

   Seek emergency medical attention or call the Poison Help line at
   1-800-222-1222.

   Overdose symptoms may include drowsiness, agitation, depression,
   double vision, thinking problems, problems with speech or
   coordination, fainting, and seizure (convulsions).

What should I avoid while taking topiramate?

   Do not drink alcohol. Dangerous side effects or increased seizures may
   occur.

   Avoid becoming overheated or dehydrated in hot weather. Topiramate can
   decrease sweating and increase body temperature, leading to
   life-threatening dehydration (especially in children).

   Ketogenic or "ketosis" diets that are high in fat and low in
   carbohydrates can increase the risk of kidney stones. Avoid the use
   of such diets while you are taking topiramate.

   Topiramate may cause blurred vision or impair your thinking or
   reactions. Avoid driving or operating machinery until you know how this
   medicine will affect you.

   Also avoid activities that could be dangerous if you have an unexpected
   seizure, such as swimming or climbing in high places.

What other drugs will affect topiramate?

   Using topiramate with other drugs that make you drowsy can worsen this
   effect. Ask your doctor before using opioid medication, a sleeping
   pill, a muscle relaxer, or medicine for anxiety or depression.

   Tell your doctor about all your other medicines, especially:
     * lithium;
     * metformin;
     * birth control pills;
     * glaucoma medication; or
     * other seizure medicines--carbamazepine, divalproex sodium,
       phenytoin, valproic acid, or zonisamide.

   This list is not complete. Other drugs may affect topiramate, including
   prescription and over-the-counter medicines, vitamins, and herbal
   products. Not all possible drug interactions are listed here.

Where can I get more information?

   Your pharmacist can provide more information about topiramate.
     __________________________________________________________________

   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.
   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.

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