Topiramate

Medication Information Leaflet

What is this medication for?

Topiramate is used to control seizures (fits) and other problems related to the nervous system. It can also be used for migraine prevention. 

How should I take/use this medication?

Follow the instructions on your medication label and take the medication as prescribed by your doctor.

You can take this medication with or without food.

Swallow the tablets with a glass of water. If you are unable to swallow the tablet, you may crush it and add it to a small amount of food (such as yoghurt, ice-cream, syrup) or water. 

You may not experience any benefits immediately after starting the medication as it may take up to a few weeks before this medication can exert its full effects. You should continue to take your medication regularly as instructed by your doctor even if you feel well. Stopping your medication without informing your healthcare professional may cause your condition to worsen quickly. 

Do not stop taking or adjust the dose of this medication without consulting your healthcare professional. 

What should I do if I forget to take/use this medication?

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, take only the usual dose. Do not double your dose or use extra medication to make up for the missed dose. 

What precautions should I take?

Inform your healthcare professional if you have the following medical conditions before starting on Topiramate:
  • Eye problems, especially glaucoma
  • Liver problems
  • Kidney problems, especially history of kidney stones or are getting dialysis
  • History of metabolic acidosis (blood and body fluid abnormality)
  • On ketogenic diet (A very low carbohydrate and high fat diet under the supervision of a dietician and neurologist)
  • Drug allergies

For women: Tell your doctor if you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side effects with continuing/starting this medication.

Consult your healthcare professional immediately if your seizures get worse or become different after you start on this medication. 

Be careful when driving or operating machinery as this medication may cause drowsiness or blurred vision. 

What are some common side-effects of this medication?

Like all medicines, this medication may cause some possible side effects but not everyone experiences them. Consult your healthcare professional if any of the side effects lasts more than a few days or become severe and bothersome.

The common side effects of Topiramate include:
  • Dizziness
    • Get up slowly from sitting or lying down position
  • Drowsiness or double vision or blurred vision
    • Avoid driving or engaging in activities that requires concentration
  • Diarrhoea
    • Drink more water to replace loss of fluids
  • Nausea, vomiting
    • Take the medication with or after food to reduce nausea and vomiting
    • Avoid food that is too rich, spicy or has strong smells
  • Loss of appetite or weight loss
  • Reduced sweating and increased body temperature
    • Drink plenty of fluids before and during physical activities such as exercises or exposure to warm weather
  • Numbness in the hands and feet (“pins and needles” sensation), 

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:
  • Swollen face / eyes/ lips / tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body
If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

If the following serious side effects happen, you should consult your healthcare professional immediately:
  • Blistering, peeling, red skin rash due to Stevens-Johnson syndrome (SJS) or Toxic Epidermal Necrolysis (TEN)
    • SJS and TEN are rare and serious skin reactions. Symptoms include face swelling, blisters on skin, skin rashes that spread within hours to days. It usually occurs within the first few months (monitor closely for the first 3 months) of treatment. 
    • As SJS and TEN progress rapidly, please consult your healthcare professional if you show the first sign of a rash.
  • Difficulty thinking, remembering information or solving problems, being less alert or aware, feeling very sleepy with low energy
  • Difficulty or pain in urinating, blood in urine, sudden reduction in urine volume, lower back pain
  • Kidney stones
    • Drink plenty of fluids when taking topiramate
  • Sudden worsening in eyesight, red eye or eye pain
  • Prolonged fever, sore throat and mouth sores
  • Unusual bruises or bleeding
  • Poor muscle coordination, muscle weakness and pain
  • New persistent rashes

In rare cases, this medication may cause the following changes to a person’s mental condition, especially in the first few weeks of treatment or during dose changes:
 
  • Worsening agitation, restlessness, violent behaviour, or
  • New or worsening thoughts of harming yourself or ending your life
  • Other changes in mood or behaviour
 
Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own. 
 
Do not stop taking this medication on your own without discussing with your doctor. 
 
It is important to note that your doctor has prescribed this medication as he/ she feels you will benefit more from taking this medication over the possible side effects that it may cause, which have a low chance of occurring. Most people take this medication without any such problems.

What food or medication should I avoid when I take this medication?

Avoid drinking alcohol while taking this medication as it can cause excessive drowsiness. 

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.




Disclaimers
If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.


This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.


Last updated on Aug 2021




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Topiramate

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