What is Topiramate: Uses, Warnings & Interactions

How to take Topiramate

• 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.

• Take topiramate tablets or capsules before, during, or after a meal.

• How to take topiramate tablets:

  • Swallow topiramate tablets whole with a glass of water. Do not break, crush, or chew them. 

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

• How to take topiramate capsules:

  • Capsules can be swallowed whole with a drink of water or opened and sprinkled on one teaspoon of soft food like applesauce. 

  • When taking topiramate sprinkled on food, swallow the mixture right away without chewing. Then, drink a glass of water. Do not save the mixture for later.

  • Store topiramate capsules at room temperatures below 77˚F in a dry place. Keep the capsules away from moisture.

• How to take topiramate extended-release capsules:

  • Swallow the capsule whole with a glass of water. Do not crush, chew, or open it.

  • DO NOT open the extended-release capsule and mix the contents with food. 

  • Store topiramate extended-release capsules in a tightly closed container in a dry place at room temperatures between 68˚F–77˚F. Protect the capsules from moisture and light.

• How to take Qudexy XR capsules:

  • Swallow the capsule whole with a drink of water. Do not crush or chew it.

  • Qudexy XR capsules can be opened and sprinkled on a spoonful of soft food. Read the Medication Guide for instructions.

  • Qudexy XR capsules are not contraindicated with alcohol use.

  • Store Qudexy XR capsules in a tightly closed container in a dry place at room temperatures between 68˚F–77˚F. Protect from moisture.

• How to take Eprontia topiramate oral solution:

  • Topiramate oral solution (Eprontia) can be taken with or without food. 

  • Use a calibrated medication measuring device such as an oral syringe to measure doses. Do not use kitchen measuring spoons, tableware, or other measuring devices.

  • Throw away any unused medication after 90 days.

  • Store topiramate oral solution in a tightly-closed container at room temperatures between 68˚F–77˚F. Do not freeze or expose the bottle to excessive heat.

• Drink plenty of fluids throughout the day to help prevent kidney stones or other kidney problems.

What to do if you miss a dose of Topiramate

• If a dose of immediate-release topiramate 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.

• Ask the prescriber what to do if a dose of extended-release topiramate is missed.

• 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.

Topiramate contraindications

• The FDA-approved prescribing information does not list any absolute contraindications for immediate-release topiramate formulations. 

• Extended-release topiramate capsules are contraindicated in anyone who has had a drink of alcohol six hours before or after taking the capsule.

Topiramate warnings

• Tell any doctor or other healthcare provider who treats you that you are taking topiramate, especially if you are having surgery. 

• The prescriber will need to schedule regular visits and tests to monitor treatment and possible problems. Keep all appointments.

• Tell the doctor if you are pregnant or planning to become pregnant. If you become pregnant while taking topiramate, immediately tell the prescribing healthcare professional.

• Tell the doctor if you are breastfeeding or have:

  • Kidney problems or kidney stones

  • Liver problems

  • A history of metabolic acidosis

  • A history of depression, mood disorders, suicidal thoughts, or suicidal behaviors

  • Brittle, weak, or soft bones

  • Problems breathing

  • Glaucoma or other eye problems

  • Diarrhea

  • A growth problem

• If you are on a high-fat, low-carbohydrate diet, tell the doctor 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

  • Vision changes

  • Angle-closure glaucoma

  • High acid levels in the blood

  • High ammonia levels in the blood 

  • Lowered body temperature 

  • Slowed growth (in children)

  • Severe drug 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.

• Topiramate may cause you to overheat or not sweat as much. Be careful in hot weather or when exercising.

• Do not suddenly stop taking topiramate without talking to the prescriber. Doses may need to slowly decrease when it’s time to stop.

Topiramate interactions

• Topiramate 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, sleeping pills, benzodiazepines, barbiturates, antihistamines, or similar drugs 

  • Oral diabetes medications

  • Birth control pills

  • Acetazolamide, amitriptyline, hydrochlorothiazide, lithium, methazolamide, valproic acid, zonisamide

• Avoid drinking alcohol or taking CBD products while taking Topamax.

• DO NOT drink alcohol six hours before or six hours after taking a dose of extended-release topiramate.

• Tell doctors, dentists, or any other healthcare providers treating you about topiramate use before they prescribe new medications.

Find more information about Topamax (topiramate) interactions to avoid here.