TOPAMAX (Topiramate)

What is this medication?

Topiramate, Topamax
Anticonvulsive Agent

Topiramate/Topamax is officially indicated for migraine prophylaxis and seizures.  It is also prescribed off-label to help manage antipsychotic-induced weight gain, binge eating disorder, prevention of tension/cluster headaches, and for essential tremor. (may be used for other conditions not listed)

How does this medication work?

The exact mechanism of Topiramate/Topamax is not full known however it is thought that the anticonvulsant effects are due to a combination of effects of voltage-dependent sodium channels in neurons, enhanced GABA-A activity, inhibition of carbonic anhydrase, and inhibited AMPA/kainite/glutamate receptors.

How should I take this medication?

Oral: 25-400mg daily divided into one or two dosages depending on condition it is used for, efficacy and patient tolerance to side effects

How to Take: Follow instructions provided by physician/pharmacy label, swallow whole due to bitter taste, take consistently at same times each day unless otherwise directed, store at room temperature.

You Need to Avoid: Do not mix with alcohol due to increased suppression of central nervous system and if used should be done so with extreme caution.  Extended release formulations cannot be mixed with alcohol at all.  Do not stop this medication abruptly due to possibility of increasing seizure frequency or exacerbation of migraine.  Ketogenic diets may increase risk of metabolic acidosis associated with this medication rarely.

What should I watch for while using this medication?

Before starting Topiramate/Topamax make sure your physician is aware of any allergies or medications you currently take, if you have kidney disease, liver disease, a history of depression, suicidal tendencies, an eating disorder, or are pregnant or breastfeeding.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Paresthesia (tingling sensation in skin), fatigue, drowsiness, dizziness, memory impairment, decreased serum bicarbonate, hyperammonemia, weight loss, abdominal pain, anorexia, dysgeusia, nausea, diarrhea, upper respiratory tract infection, or fever.

Note this is not a complete list of side effects, only common ones.