Topiramate - oral

Patient Medicine Information
Why do I need this medicine?
Topiramate is used on its own or together with other medicines to treat epilepsy (also known as fits or seizures).

This medicine is also used to prevent migraine (severe throbbing or pulsating sensation usually affecting one side of the head and is often accompanied by nausea, vomiting, and sensitivity to light and sound).
How do I take this medicine?
Take Topiramate exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

Topiramate is available as a tablet, capsule, or oral suspension or solution.

If you are taking the tablet, swallow it whole. Do not chew or break the tablet.

If you are taking the capsule, you may either swallow it whole or open it and sprinkle the entire contents on a teaspoonful of soft food. Swallow the mixture immediately without chewing. Drink some water to ensure that the full dose is taken.

If you are taking an oral suspension or solution, use the measuring device (e.g. oral syringe) provided to measure your dose. Shake the oral suspension bottle well before you take it to ensure that the liquid is evenly mixed.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition, response, and tolerability to the medication.

Topiramate must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.
What should I do if I have forgotten to take this medicine?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.
When should I not use this medicine?
Do not take Topiramate to prevent migraine headaches if you are pregnant or if you are of childbearing potential. If you become pregnant while being treated with this medicine, alert your doctor immediately. Topiramate may cause harm to your unborn child. You must use proven birth control methods while taking this medicine.
What should I take note of while using this medicine?
Inform your doctor if you have the following conditions:
  • personal or family history of kidney stones
  • excess levels of calcium in the urine
  • history of eye problems
  • history of metabolic acidosis (too much acid in the body fluids)
  • severe lung disease
  • on a high-fat diet (ketogenic diet)
  • diarrhoea
  • kidney disease
  • liver disease
Let your doctor know if you are pregnant or breastfeeding.

It is important that you do not get pregnant while being treated with Topiramate. You may wish to discuss birth control methods with your doctor or pharmacist.

Be sure to check with your doctor or pharmacist before giving this medicine to a child. Children may be more sensitive to the side effects.

Ensure proper hydration while on Topiramate therapy, and prior to or during activities such as exercise or exposure to warm temperature.

Inform your doctor if there is no improvement in seizure control.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
  • Pregnancy tests must be done before treatment to know if this medicine is suited for you to take.
  • Routine tests (e.g. kidney function, electrolyte levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
  • Regular monitoring of signs of depression, suicidal thoughts and behaviour, and changes in vision may also be needed.
What side effects could I experience?
Topiramate may cause dizziness, drowsiness, or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Other side effects include any of the following: nausea, vomiting, diarrhoea, constipation, stomach pain or discomfort, cough, stuffy or runny nose, sore throat, loss of appetite, distorted sense of taste, joint pain, muscle pain, spasm, twitching or weakness, chest pain, tiredness, nervousness, double vision, numbness or tingling sensation in the hands and feet, weight gain or loss, rash, hair loss, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • worsening or more frequent seizures
  • irregular or abnormal heartbeat
  • decreased sweating, high fever or a fever that does not go away
  • problems with concentration, attention, memory, or speech
  • unusual changes in mood or behaviour (being too depressed, agitated or having compulsive and impulsive behaviour)
  • rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Can I take this with other medicines?
Inform your doctor and pharmacist if you are taking any of these medicines:
  • other medicines for epilepsy e.g. carbamazepine, phenytoin, valproic acid, zonisamide
  • medicines for diabetes e.g. glibenclamide, pioglitazone, metformin
  • warfarin (blood-thinning medicine)
  • amitriptyline (medicine to treat depression)
  • lithium (medicine for mood disorder)
  • digoxin (medicine for irregular heartbeat)
  • hydrochlorothiazide (water pill or medicine for water retention)
This list does not include all medicines that may interact with Topiramate.

Inform your doctor if you are currently taking birth control pills as this medicine may reduce the effectiveness of hormonal contraceptives. You should not stop or start any birth control pills without first informing your doctor. Ask your doctor about using non-hormonal birth control as an alternative while being treated with Topiramate.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
What special dietary instructions should I follow?
Avoid alcohol.
How should I store this medicine?
Store in a cool, dry place away from the reach of children.

The oral solution should be used within 60 days after opening, while the oral suspension must be used within 1 month.

Medicines must not be used past the expiry date.
This information is independently developed by MIMS based on topiramate - oral and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2023 MIMS. All rights reserved. Powered by
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