{"id":32211,"date":"2021-06-11T09:30:20","date_gmt":"2021-06-11T13:30:20","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=32211"},"modified":"2025-02-12T10:05:39","modified_gmt":"2025-02-12T15:05:39","slug":"topamax-and-alcohol","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/topamax-and-alcohol\/","title":{"rendered":"What happens when you mix Topamax and alcohol?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">If you experience migraine, you\u2019re not alone. Migraine is the <\/span><a href=\"https:\/\/migraineresearchfoundation.org\/about-migraine\/migraine-facts\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">third most prevalent illness<\/span><\/a><span style=\"font-weight: 400;\"> worldwide\u2014almost one in four households include someone with migraine. Migraine can be incapacitating, causing missed work and school days. In addition to throbbing pain, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/pharmacist-knows-best-migraine\/\"><span style=\"font-weight: 400;\">migraine<\/span><\/a><span style=\"font-weight: 400;\"> is often accompanied by many other uncomfortable symptoms, such as visual disturbances, nausea, vomiting, and dizziness.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">With <\/span><a href=\"https:\/\/americanheadachesociety.org\/news\/how-to-participate-migraine-headache-awareness-month\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">June<\/span><\/a><span style=\"font-weight: 400;\"> being Migraine and Headache Awareness Month, we want to shine a light on things that can affect people with migraines. One such complication is drinking with your migraine medication, such as Topamax.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What is Topamax?<\/span><\/h2>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/topamax\"><span style=\"font-weight: 400;\">Topamax<\/span><\/a><span style=\"font-weight: 400;\"> (topiramate) is a popularly prescribed drug used to <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=21628112-0c47-11df-95b3-498d55d89593\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">treat<\/span><\/a><span style=\"font-weight: 400;\"> certain types of <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/epilepsy-treatment-and-medications\"><span style=\"font-weight: 400;\">seizures<\/span><\/a><span style=\"font-weight: 400;\"> in people ages two years and older. The medication is also used to prevent <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/migraine-treatment-and-medications\"><span style=\"font-weight: 400;\">migraine<\/span><\/a><span style=\"font-weight: 400;\"> in people ages 12 years and older. Topamax is not used to treat a migraine attack. It is only used for prevention.<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/topamax\/what-is\"><span style=\"font-weight: 400;\">Topamax<\/span><\/a><span style=\"font-weight: 400;\">, like any other medication, has many potential side effects. Some common side effects of Topamax include weakness, dizziness, drowsiness, <a href=\"https:\/\/www.singlecare.com\/blog\/topamax-weight-loss\/\">appetite\/weight loss<\/a>, mood changes (anxiety, depression, suicidal thoughts and behavior), memory and sleep problems, and a feeling of pins and needles.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">One common question among people who take Topamax is: Can I mix Topamax and alcohol?<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Can you take Topamax with alcohol?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Unfortunately, Topamax and alcohol do not mix. The <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/020505s057_020844s048lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">manufacturing information<\/span><\/a><span style=\"font-weight: 400;\"> for Topamax warns, \u201cDo not drink alcohol while taking Topamax. Topamax and alcohol can affect each other, causing side effects such as sleepiness and dizziness.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As for other forms of Topamax, it\u2019s also a no.<\/span><\/p>\n<p><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=2dc7957e-a3e5-46bb-aa66-f3250f872f5e\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Trokendi XR<\/span><\/a><span style=\"font-weight: 400;\"> is an extended-release form of topiramate, the same ingredient in Topamax. Trokendi XR is indicated to treat certain types of seizures in people ages 6 years and older. It is also used to prevent migraine in patients ages 12 years and older. Alcohol is contraindicated (must not be used) within six hours of taking Trokendi XR. The manufacturer of Trokendi XR states that the way the drug works is \u201csignificantly altered\u201d when in the presence of alcohol. This could result in significantly higher levels soon after taking <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/trokendi-xr\/what-is\"><span style=\"font-weight: 400;\">Trokendi XR<\/span><\/a><span style=\"font-weight: 400;\"> and too-low levels later on.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/205122s003s005lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Qudexy XR<\/span><\/a><span style=\"font-weight: 400;\"> is another extended-release form of topiramate. The manufacturer warns, \u201cDo not drink alcohol while taking<\/span> <a href=\"https:\/\/www.singlecare.com\/prescription\/qudexy-xr\"><span style=\"font-weight: 400;\">Qudexy XR<\/span><\/a><span style=\"font-weight: 400;\">. Qudexy XR and alcohol can cause serious side effects such as severe sleepiness and dizziness and an increase in seizures.\u201d<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-32408 size-full\" src=\"https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121.png\" alt=\"Topamax and alcohol\" width=\"1920\" height=\"900\" srcset=\"https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121.png 1920w, https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121-300x141.png 300w, https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121-1024x480.png 1024w, https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121-768x360.png 768w, https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Mixup_Chart_061121-1536x720.png 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<h2><span style=\"font-weight: 400;\">Topamax and alcohol use disorder<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Although Topamax is often used to treat seizures or prevent migraines, it has some <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/off-label-prescription-drugs\/\"><span style=\"font-weight: 400;\">off-label<\/span><\/a><span style=\"font-weight: 400;\"> uses, too. Although there is not much data, some <\/span><a href=\"https:\/\/www.aafp.org\/afp\/2016\/0315\/p457.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">studies<\/span><\/a><span style=\"font-weight: 400;\"> show that Topamax can help decrease alcohol consumption. A review by the <\/span><span style=\"font-weight: 400;\">Agency for Healthcare Research and Quality (AHRQ) concluded that topiramate could reduce the number of drinking days, heavy drinking days, and drinks per day based on two trials.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Can you drink alcohol while taking anticonvulsants?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">According to the <\/span><a href=\"https:\/\/www.niaaa.nih.gov\/publications\/brochures-and-fact-sheets\/harmful-interactions-mixing-alcohol-with-medicines\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">National Institute on Alcohol Abuse and Alcoholism<\/span><\/a><span style=\"font-weight: 400;\">, alcohol should not be mixed with <\/span><i><span style=\"font-weight: 400;\">any<\/span><\/i><span style=\"font-weight: 400;\"> anticonvulsant due to increased drowsiness and dizziness. In addition to Topamax, these medications include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dilantin (phenytoin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Keppra (levetiracetam)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Klonopin (clonazepam)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lamictal (lamotrigine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lyrica (pregabalin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Neurontin (gabapentin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Phenobarbital\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tegretol (carbamazepine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Trileptal (oxcarbazepine)<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Does alcohol make seizures worse?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Keep in mind that everyone is different. Talk with your doctor to determine if you can drink alcohol at all, and if so, how much you can safely drink depending on your symptoms, medical history, and any medications you take.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.epilepsy.com\/learn\/triggers-seizures\/alcohol\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Small amounts of alcohol<\/span><\/a><span style=\"font-weight: 400;\">, such as an occasional one or two drinks, generally do not increase seizure activity or affect seizure medications in your body. Seizures related to alcohol are often associated with alcohol withdrawal rather than the act of drinking; however, consuming three or more alcoholic beverages may significantly increase the risk of seizure. <\/span><a href=\"https:\/\/www.cdc.gov\/drink-less-be-your-best\/facts-about-excessive-drinking\/index.html\"><span style=\"font-weight: 400;\">Binge drinking<\/span><\/a><span style=\"font-weight: 400;\"> and resulting alcohol withdrawal may lead to status epilepticus, which could potentially be fatal.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Chronic alcohol abuse (alcoholism) may be linked to the development of epilepsy in some instances. People who have had seizures after binge drinking may begin to have seizures even when not consuming alcohol.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If your doctor says you may consume alcohol in small amounts or moderation, you should:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoid binge drinking because binge drinking can cause withdrawal seizures.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Not abuse alcohol\u2014get help if you need it.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drink small amounts\u2014less than three drinks\u2014and drink slowly.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Talk to your doctor about alcohol consumption as related to seizures and medication.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Not drive (this goes for alcohol consumption in general, of course) due to impaired coordination and increased sedation and dizziness.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Does alcohol make migraines worse?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">According to the <\/span><a href=\"https:\/\/americanmigrainefoundation.org\/resource-library\/alcohol-and-migraine\/#:~:text=Population%2Dbased%20studies%20performed%20in,migraine%20and%20non%2Dmigraine%20headache.\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">American Migraine Foundation<\/span><\/a><span style=\"font-weight: 400;\">, alcohol may trigger a migraine attack. Alcohol can trigger an attack within several hours. It can also cause a hangover headache. If you find that a small amount of alcohol does not trigger a migraine attack or a hangover headache, consult your doctor about appropriate amounts to consume. However, keep in mind that the medication(s) you take to prevent and treat migraines may interact with alcohol. Your doctor can examine your medical history and conditions as well as any medications you take, to determine how much alcohol, if any, is safe for you to consume.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Is Topamax hard on the liver?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">People with liver problems may not eliminate topiramate properly, leading to increased topiramate levels, potentially increasing side effects. The manufacturer suggests using topiramate with caution in people with impaired liver function.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In rare cases, <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=e999cb0a-8e45-4fdc-9b52-f3661f5dfc33#L2191b9a3-456c-4e93-bf41-ff37c2d96316\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">people with liver problems<\/span><\/a><span style=\"font-weight: 400;\"> who take Topamax, especially when also taking valproic acid, may be at higher risk for <\/span><span style=\"font-weight: 400;\">hyperammonemia (a dangerous condition caused by high levels of ammonia) with or without encephalopathy (brain disease or damage). Symptoms may include unexplained tiredness, vomiting, or mental status changes and should receive immediate medical attention.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Suicidal thoughts and behavior<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It is important to recognize that anticonvulsant drugs, including Topamax, increase the risk of suicidal thoughts and behavior, regardless of the indication for which the person is taking the medication. When taking an anticonvulsant, the patient must be monitored closely for mood or behavior changes, depression, and suicidal thoughts and behavior.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2872355\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">study<\/span><\/a><span style=\"font-weight: 400;\"> looked at data about alcohol use and suicide. It found that \u201c<\/span><span style=\"font-weight: 400;\">alcohol abuse is a means of easing one\u2019s psychological stress but, at the same time, impacts on all other factors, rendering suicide more likely.\u201d<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Since both alcohol and Topamax can potentially cause suicidal thoughts or behavior individually, the impact together could be greater.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Consult your doctor<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medications and alcohol affect everyone differently. Talk to your healthcare provider if you have questions about Topamax and alcohol interactions or about alcohol in combination with your medical conditions.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you experience migraine, you\u2019re not alone. Migraine is the third most prevalent illness worldwide\u2014almost one in four households include someone with migraine. Migraine can be incapacitating, causing missed work and school days. In addition to throbbing pain, migraine is often accompanied by many other uncomfortable symptoms, such as visual disturbances, nausea, vomiting, and dizziness.\u00a0 [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":32401,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[8742,788,4316,8905],"coauthors":[10668],"class_list":["post-32211","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-alcohol-interactions","tag-drug-safety","tag-migraine","tag-seasonal","franchise-the-mix-up","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What happens when you mix Topamax and alcohol?<\/title>\n<meta name=\"description\" content=\"Don&#039;t mix Topamax and alcohol or any other anticonvulsant. Plus alcohol can trigger migraines, and three or more drinks can increase the risk for seizures.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/topamax-and-alcohol\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The problem with mixing Topamax and alcohol\" \/>\n<meta property=\"og:description\" content=\"How your favorite cocktail interacts with this migraine med\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.singlecare.com\/blog\/topamax-and-alcohol\/\" \/>\n<meta property=\"og:site_name\" content=\"The Checkup\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/singlecare\" \/>\n<meta property=\"article:published_time\" content=\"2021-06-11T13:30:20+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-02-12T15:05:39+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.singlecare.com\/blog\/wp-content\/uploads\/2021\/05\/Blog_Mixup_061121_Topamax_and_alcohol.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1920\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Karen Berger, Pharm.D.\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"The problem with mixing Topamax and alcohol\" \/>\n<meta name=\"twitter:description\" content=\"How your favorite cocktail interacts with this migraine med\" \/>\n<meta name=\"twitter:creator\" content=\"@SingleCare\" \/>\n<meta name=\"twitter:site\" content=\"@SingleCare\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Karen Berger, Pharm.D.\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/\"},\"author\":{\"name\":\"Mariusz Labedzki\",\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/#\\\/schema\\\/person\\\/232380d21234706e6360acfa9c895934\"},\"headline\":\"What happens when you mix Topamax and alcohol?\",\"datePublished\":\"2021-06-11T13:30:20+00:00\",\"dateModified\":\"2025-02-12T15:05:39+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/\"},\"wordCount\":1089,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/wp-content\\\/uploads\\\/2021\\\/05\\\/Blog_Mixup_061121_Topamax_and_alcohol.png\",\"keywords\":[\"Alcohol interactions\",\"Drug safety\",\"Migraine\",\"Seasonal\"],\"articleSection\":[\"Drug Info\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/\",\"url\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/\",\"name\":\"What happens when you mix Topamax and alcohol?\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/topamax-and-alcohol\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.singlecare.com\\\/blog\\\/wp-content\\\/uploads\\\/2021\\\/05\\\/Blog_Mixup_061121_Topamax_and_alcohol.png\",\"datePublished\":\"2021-06-11T13:30:20+00:00\",\"dateModified\":\"2025-02-12T15:05:39+00:00\",\"description\":\"Don't mix Topamax and alcohol or any other anticonvulsant. 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