Topiramate is a prescription medicine used to treat seizures (epilepsy) and pre
vent migraines. It belongs to a class of medications called ‘carbonic anhydrase inhibitors.’
Uses of Topiramate
- To treat epilepsy - as a single medicine in people aged over six years
- To treat epilepsy – in combination with other medicines in people aged over two years
- To prevent migraine headaches in adults
Contraindications of Topiramate
When should one not use Topiramate
- If you are allergic to the medicine or any other substances used in the medicine
- To prevent migraine attacks in women of childbearing potential, if not using birth control methods
Side effects of Topiramate
Common side effects of this drug are:
- New onset or worsening of existing depression (most common)
- Seizures (fits)
- Mood changes – anxiety, getting irritated quickly or disoriented
- Difficulty to concentrate, think and memory problems
- Kidney stones, painful urination
- Metabolic acidosis
- Increased acid levels in blood (troubled breathing, irregular heartbeats, etc.)
- Absent or decreased sweating
- Suicidal tendencies
- Vision problems
- Glaucoma (rare)
Precautions and Warnings of Topiramate
Can I take Topiramate during pregnancy?
Consult your doctor if you are pregnant or planning a pregnancy before taking Topiramate. Topiramate is known to have the potential to cause defects in unborn babies (teratogenic) and should not be given in pregnancy. If it is necessary and no alternatives exist, strict supervision is recommended at your own risk.
Can I take Topiramate while breastfeeding?
Topiramate is not recommended in breastfeeding women as significant levels of the medicine are secreted in breast milk.
Can I drive if I have consumed Topiramate?
As Topiramate acts on the brain, it is expected to cause drowsiness, dizziness and vision problems. It is advisable not to drive in the first few months after starting the medicine and later on, do not drive for longer durations.
Can I consume alcohol with Topiramate?
Avoid alcohol while on medication of Topiramate as it may intensify drowsiness.
Other General Warnings
Talk to your doctor if
- You have kidney-related problems (kidney stones)
- You have a history of acidosis (high levels of acids or electrolytes in blood)
- You have a growth problem
- You have a high-fat diet
- You have liver or eye problems
- You have any problems in concentration, memory or thinking
Mode of Action of Topiramate
How Does It Work?
Seizures occur due to decreased levels of a substance called GABA (Gamma Amino Butyric acid), which regulates signals and messages in the brain. Topiramate acts by specific mechanisms and increases the GABA levels, thereby controlling seizures and preventing migraine....
Interactions of Topiramate
Interactions with other medicines
- Medicines used to treat diabetes (Pioglitazone, Metformin, Glibenclamide)
- Medicines used to treat depression or anxiety (Venlafaxine, Flunarazine, Amitriptyline)
- Medicines used to treat heart disease or blood pressure (Propranolol, Diltiazem, Hydrochlorothiazide)
- Medicines used to treat psychiatric problems (Risperidone, Lithium)
- Other anti-seizure medications
Interactions with food items
Topiramate does not interact with food. It can be taken before or after meals.
Dietary Restrictions of Topiramate
No information is available on dietary restrictions while you are taking Topiramate, consult your doctor or pharmacist for further information.
Dosage of Topiramate
If you suspect an overdose of Topiramate, contact doctor immediately; symptoms may include feeling sleepy, tired, less alert or have blurred vision. You may require hospital admission and are advised to be careful. Avoid any overdosage....
Missed a Dose
Take the missed dose as early as you remember it. However, if it is less than 6 hours before you are scheduled to take your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to compensate for a missed dose. If you have missed more than two doses, contact your doctor....
Dr. Ravi Kakarla
Dr. Ritu Budania
MBBS, MD (Pharmacology)
Frequently Asked Questions (FAQs)
Q: How long does it take for Topiramate to act? Will I get instant relief?
A: Topiramate takes time to act. In case of seizures, it will take about two weeks and up to 3 months if you are taking it to prevent migraines.
Q: I am not having any seizures or migraines. Can I stop the medication of Topiramate?
- Topiramate is a safe medicine if you take it as per schedule and can be taken for long periods of time
- If you want to stop taking this medicine, you should consult your doctor
- If you are taking this medicine to treat seizures, do not stop it suddenly as it will cause withdrawal symptoms and the dose needs to be tapered down gradually
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