About topiramate
Antiseizure medicine; migraine preventive
Used for
- Treats certain types of seizures, alone or with other medicines.
- Helps prevent migraine headaches; it does not treat an attack already underway.
Usual adult dose
Epilepsy: usually starts at 25–50 mg daily, increased gradually; common maintenance is 100–400 mg daily. Migraine prevention: usually 50 mg twice daily after gradual increases.
Usual dose in children
Epilepsy: dose is based on weight and seizure type, increased gradually under specialist supervision. Migraine prevention: sometimes used from age 12, commonly 50 mg twice daily after gradual increases.
Common side effects
- Tingling in hands or feet, reduced appetite, weight loss.
- Sleepiness, dizziness, slowed thinking, memory or word-finding problems.
- Taste changes, nausea, diarrhea.
- Kidney stones; rarely, sudden vision problems or reduced sweating.
Important warnings
- Do not stop suddenly; seizures may worsen. Dose reductions should be gradual.
- Can cause serious eye problems, metabolic acidosis, kidney stones, or overheating.
- May cause mood changes or suicidal thoughts; report these promptly.
- Can harm an unborn baby, including cleft lip or palate; may reduce hormonal contraceptive effectiveness.
Pregnancy
May cause birth defects and impaired fetal growth. Avoid for migraine prevention during pregnancy; epilepsy treatment requires specialist risk assessment.
Breastfeeding
Passes into breast milk. Infant drowsiness, diarrhea, poor feeding, or poor weight gain may occur; monitor with a clinician.
Interactions
- Valproate can increase risks of high ammonia and low body temperature.
- Carbamazepine or phenytoin may lower topiramate levels.
- Topiramate may reduce hormonal contraceptive effectiveness, especially at higher doses.
- Other medicines causing drowsiness or metabolic acidosis may increase adverse effects.
AI-generated from general medical knowledge, not from this product's official leaflet. It may be incomplete or out of date. Not medical advice — ask a pharmacist or doctor before making any decision.