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Topiramate (By mouth)

Topiramate (toe-PIR-a-mate)

Treats and prevents seizures, and helps prevent migraine headaches.

Brand Name(s):

Qudexy XR, Topamax, Trokendi XR

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to topiramate, or if you are pregnant.

How to Use This Medicine:

Capsule, Long Acting Capsule, Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Tablet: Swallow whole. Do not break, crush, or chew the tablet. It has a very bitter taste.
  • Capsule or extended-release capsule: Do not crush or chew the capsule. Swallow whole or open the capsule and pour the medicine into a small amount (1 teaspoon) of soft food, such as applesauce. Swallow the mixture right away without chewing. Do not store the mixture for use at a later time.
  • Drink extra fluids so you will urinate more often and help prevent kidney problems.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you miss a dose or forget to use your medicine, use it as soon as you can. If your next regular dose of Topamax® is less than 6 hours away, wait until then to use the medicine and skip the missed dose. If you miss more than 1 dose of Topamax®, call your doctor for instructions.
  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Do not drink alcohol with Qudexy™ XR or Topamax®. Do not drink alcohol for 6 hours before and 6 hours after you take the Trokendi XR™ capsule.
  • Some medicines can affect how topiramate works. Tell your doctor if you are using acetazolamide, dichlorphenamide, dichloralphenazone, digoxin, lithium, metformin, zonisamide, other medicine for seizures (such as carbamazepine, phenytoin, valproic acid), or birth control pills.
  • Tell your doctor if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.

Warnings While Using This Medicine:

  • It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
  • Tell your doctor if you are breastfeeding, or if you have kidney disease, liver disease, glaucoma, lung or breathing problems, osteoporosis, or a history of depression or mood disorders. Tell your doctor if you are on a ketogenic diet (high in fat and low in carbohydrates).
  • This medicine may cause the following problems:
    • Eye pain or vision changes, including glaucoma
    • Changes in body temperature
    • Metabolic acidosis (too much acid in the blood)
    • Kidney stones
  • This medicine may increase depression or thoughts of suicide. Tell your doctor right away if you start to feel more depressed or think about hurting yourself.
  • This medicine may make you dizzy, drowsy, or tired. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Bloody or cloudy urine, painful urination, sudden lower back or stomach pain
  • Changes in vision, eye pain
  • Confusion, problems with walking, clumsiness, dizziness, or trouble talking, concentrating, or remembering
  • Feeling agitated, depressed, nervous, or irritable, thoughts of hurting yourself or others, unusual mood or behavior
  • Fever, decreased sweating
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet
  • Rapid, deep breathing, loss of appetite, fast or uneven heartbeat
  • Vomiting, unusual drowsiness, tiredness, or weakness

If you notice these less serious side effects, talk with your doctor:

  • Change in taste
  • Nausea, diarrhea
  • Stuffy or runny nose
  • Weight loss

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 5/1/2020

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