What is Topamax: Uses, Warnings & Interactions

Take your medicine as directed. 

Please read the Medication Guide that comes with this medicine.

The dose will change weekly during the first few weeks of treatment, so make sure you understand the right dose to take.

Take Topamax doses before, during, or after a meal.

How to take Topamax tablets:

• Swallow Topamax tablets whole with a glass of water. Do not break, crush, or chew them. The tablets have a very bitter taste.

• Store Topamax tablets at room temperature in a dry place protected from moisture.

How to take Topamax capsule:

• Capsules can be swallowed whole with a drink of water. 

• Capsules can also be opened and the contents sprinkled on soft food and taken that way.

• Use about 1 teaspoon of soft food like applesauce.

• Swallow the mixture immediately without chewing. Do not save the mixture.

• Drink a glass of water after swallowing the mixture.

• Store Topamax capsules at temperatures below 77˚F in a dry place protected from moisture.

Drink plenty of fluids throughout the day to help prevent kidney problems.

If a dose is missed, take it when remembered.

If the next dose is six hours away or sooner, skip the missed dose. Take the next dose as scheduled.

Do not take extra doses to make up for a missed dose.

If two or more doses are missed, call the prescribing healthcare provider for advice.

The FDA-approved prescribing information does not list any absolute contraindications.

Tell any doctor or other healthcare provider who treats you that you are taking Topamax. 

The prescriber will need to schedule regular visits and tests to monitor effectiveness and spot any problems. Keep all appointments.

Tell the doctor if you are pregnant, breastfeeding, or have:

• Kidney problems or kidney stones

• Liver problems

• A history of metabolic acidosis

• A history of depression, mood disorders, suicidal thoughts, or suicide attempts

• Brittle or weak bones

• Problems breathing

• Glaucoma or other eye problems

• A growth problem

If you are on a high-fat, low-carbohydrate diet, tell the healthcare provider before starting topiramate.

Topiramate can cause serious problems, including:

• Kidney stones

• Metabolic acidosis

• Suicidal thoughts or behaviors

• Psychiatric or cognitive problems

• Loss of bone density (osteoporosis)

• Vision changes

• Angle-closure glaucoma

• Stunted growth (in children)

• High ammonia levels in the blood (when used with valproic acid)

• Low body temperature (when used with valproic acid)

• Severe skin or allergic reactions

It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Women of childbearing age should use birth control while taking this drug. Tell your doctor right away if you become pregnant.

This medicine may make you dizzy, drowsy, or tired. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Do not suddenly stop taking doses. Your doctor will need to slowly decrease the dose before the drug can be stopped completely.

Topamax has several significant drug interactions, so tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use, particularly:

• Other anti-seizure medications

• Drugs that make you sleepy, such as narcotic pain relievers, tranquilizers, benzodiazepines, or other CNS depressants

• Oral diabetes medications

• Birth control pills

• Acetazolamide, amitriptyline, lithium, zonisamide

Avoid drinking alcohol or taking CBD products while taking Topamax.

Tell other healthcare providers you are using this medicine before they prescribe new medications.