Before taking topiramate

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.

How to take topiramate

• 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.

Getting the most from your treatment

• 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.

Can topiramate cause problems?

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.

How to store topiramate

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

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