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Topiramate is available as a 25 mg, 50 mg, 100 mg, and 200 mg oral tablet and a 15 mg and 30 mg oral capsule.

Topiramate is an antiepitleptic that is used for:

• Seizures (partial seizures, tonic-clonic seiures, Lennox-Gastaut syndrome)
• Migraine prevention

Topiramate is an antiepileptic. It’s not exactly clear how this medication works to prevent migraines. But in order to control seizures, Topiramate blocks your brain from sending certain signals or chemicals that can overly excite your nerves. This helps to reduce the bursts of activity in your brain, which prevents seizures.

Topiramate initial dose, titration, and recommended maintenance dose varies by indication and age group. See Full Prescribing Information for recommended dosage, and dosing considerations in patients with renal impairment, geriatric patients, and patients undergoing hemodialysis.

Topiramate is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Common side effects of Topiramate:

• Feeling “pins and needles”
• Drowsiness
• Weight loss
• Nervousness
• Fatigue
• Dizziness
• Lack of appetite
• Trouble sleeping
• Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)
• Fever
• Change in taste
• Trouble moving or keeping balance

Serious side effects are rare with Topiramate. Contact your healthcare provider immediately if you experience any of the following.

• Suicidal thoughts or behaviors
• Seizures (from withdrawal)
• Vision problems: blurred vision, loss of vision, double vision, blind spots
• Serious bleeds: bleeding that’s difficult to stop, vomiting blood, blood in the urine or stool, “coffee-ground” stool
  Severe skin reactions: rash, skin pain or peeling, blisters, fever, sore throat, extreme tiredness, swelling of the face, swollen lips
• Extreme drop in body temperature: shivering, feeling tired, feeling confused, slurred speech, coma
• Dangerously high body temperature: fever, headache, dizziness, feeling confused, nausea, vomiting muscle cramps, skin that’s very warm or hot to the touch
• Dangerously high blood acid levels: feeling very tired, breathing very fast, poor appetite, irregular heartbeat, trouble thinking clearly, sharp pain near the side and back from kidney stones
• Extremely high blood ammonia levels: fatigue, poor mental alertness, vomiting

The following medications may interact with Topiramate:

• Contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day
• Monitor lithium levels if lithium is used with high-dose Topiramate

Various FDA-approved generic manufacturers

Topiramate use during pregnancy can cause major congenital
malformations, including but not limited to cleft lip and/or palate, and being small for gestational age. Topiramate should be used during pregnancy only if the potential
benefit outweighs the potential risk.

• Topamax