• Drink plenty of water while you are taking topiramate.
  • If you are female, make sure you follow the contraceptive advice you have been given.
  • If you experience any depressive mood swings or any problems with your eyesight, make an appointment to see your doctor as soon as possible.
  • Do not stop taking topiramate unless your doctor tells you to do so.
Type of medicine Antiepileptic
Used for Treatment of epilepsy
Prevention of migraine in adults
Also called Topamax®
Topamax Sprinkle®
Available as Tablets
Sprinkle capsules

Topiramate is used to control convulsions (fits) in some forms of epilepsy. It works by reducing the activity in the brain although it is not fully understood exactly how it does this. It can be used alone or alongside other antiepileptic medicines.

Topiramate is also used to help prevent migraines.

Before taking topiramate make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have liver or kidney problems.
  • If you have ever had kidney stones or have been told you have high levels of calcium in your urine.
  • If you have ever had an eye disorder.
  • If you have porphyria (a rare blood disorder).
  • If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
  • If you have ever had an allergic reaction to this or to any other medicine.
  • Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
  • Take topiramate exactly as your doctor has told you to. It is usual to start topiramate treatment on a low dose and then for this dose to be increased gradually.
  • You may take topiramate before or after food.
  • If you have been given topiramate tablets, do not chew or crush the tablets. Swallow the tablets whole with a drink of water.
  • If you have been given topiramate capsules, you may swallow the capsules whole with a drink of water or alternatively you may open them up and sprinkle the contents on to a teaspoon of some soft food such as porridge, yoghurt or custard. Swallow this mixture straight away without chewing.
  • Try to drink plenty of water while you are taking topiramate. This is especially important when you are exercising or if you work in a hot environment.
  • Try to take topiramate at the same time(s) each day to avoid missing any doses.
  • If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
  • Do not stop taking topiramate unless your doctor tells you to do so. Stopping treatment suddenly can cause problems and your doctor will probably want you to reduce your dose gradually if this is necessary.
  • Keep your regular appointments with your doctor. This is so your progress can be monitored. You may need to have eye tests and weight checks from time to time.
  • It is recommended that you do not drink alcohol while you are taking topiramate. This is because alcohol can increase feelings of drowsiness and dizziness.
  • If you are female, your doctor will discuss with you the need to avoid becoming pregnant. Make sure you follow the contraceptive advice you have been given and let your doctor know straight away if you experience any breakthrough bleeding.
  • While you are taking topiramate, there is a small risk that you may develop mood changes, distressing or depressed thoughts and feelings about suicide. If this happens, you must tell your doctor straight away.
  • People with epilepsy must stop driving. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common side-effects - these affect about 1 in 10 people who take this medicine What can I do if I experience this?
Feeling sick Eat little and often. Stick to simple foods
Dizziness, feeling sleepy or tired If this happens, do not drive or use tools or machines
Diarrhoea Drink plenty of water to replace lost fluids
Weight changes, reduced appetite If you are losing a lot of weight speak with your doctor who may advise you to increase the food you eat or take a food supplement
Tingling feelings, problems concentrating, lack of co-ordination, blurred eyesight, blocked or runny nose, nosebleeds, abdominal pain, indigestion, dry mouth, skin rash, hair loss, muscle weakness or pain, fever, difficulty sleeping, and mood swings If any of these become troublesome, speak with your doctor for advice

Important: if you experience any problems with your eyes, let your doctor know as soon as possible.

If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • If you buy any medicines check with a pharmacist that they are safe to take with this medicine.
  • Never take more than the prescribed dose. If you suspect that you have taken, or someone else has taken, an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Topamax® Tablets; Manufacturer's PIL, Topamax® Tablets, Janssen-Cilag Ltd. electronic Medicines Compendium. Dated November 2010.
  • Manufacturer's PIL, Topamax Sprinkle® Capsules; Manufacturer's PIL, Topamax Sprinkle® Capsules, Janssen-Cilag Ltd. electronic Medicines Compendium. Dated November 2010.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Prof Cathy Jackson
Last Checked:
Document ID:
3707 (v24)
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