Topiramate is used alone or together with other medicines to help treat certain types of seizures (eg, partial seizures, tonic-clonic seizures, or Lennox-Gastaut syndrome). This medicine will not cure epilepsy and will only work to control seizures for as long as you continue to take it. It is also used to help prevent migraine headaches.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Topiramate may be taken with or without food.

Swallow the Trokendi XR™ extended-release capsule whole. Do not open, crush, or chew the capsule.

Avoid drinking alcohol with Qudexy® XR or Topamax®, or avoid for 6 hours before and 6 hours after taking the Trokendi XR™ capsule.

Swallow the tablet whole. Do not break, crush, or chew it. The tablet may taste bitter if it is held in the mouth or chewed.

The Topamax® sprinkle capsule or Qudexy® XR extended-release capsule may be swallowed whole or opened and sprinkled on a small amount (1 teaspoon) of soft food like applesauce. Swallow the food mixture immediately without chewing. Do not store the mixture for use at a later time.

Drink extra water with this medicine to help prevent kidney stones.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Any vision problems, especially blurred vision, double vision, eye pain, or rapidly decreasing vision

burning, prickling, or tingling sensations

clumsiness or unsteadiness

confusion

continuous, uncontrolled back-and-forth or rolling eye movements

dizziness

drowsiness

eye redness

generalized slowing of mental and physical activity

increased eye pressure

memory problems

menstrual changes

menstrual pain

nervousness

speech or language problems

trouble in concentrating or paying attention

unusual tiredness or weakness

Less common

Abdominal or stomach pain

fever, chills, or sore throat

lessening of sensations or perception

loss of appetite

mood or mental changes, including aggression, agitation, apathy, irritability, and mental depression

red, irritated, or bleeding gums

weight loss

Rare

Blood in the urine

decrease in sexual performance or desire

difficult or painful urination

frequent urination

hearing loss

loss of bladder control

lower back or side pain

nosebleeds

pale skin

red or irritated eyes

ringing or buzzing in the ears

skin rash or itching

swelling

trouble breathing

Incidence not known

Blistering, peeling, or loosening of the skin

blisters in the mouth

blisters on the trunk, scalp, or other areas

bloating

clay-colored stools

constipation

cough

diarrhea

increased rate of breathing

joint or muscle pain

pain or tenderness in upper abdomen or stomach

red skin lesions, often with a purple center

sores, ulcers, or white spots in the mouth or on the lips

yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Decreased awareness or responsiveness

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

severe sleepiness

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Breast pain in women

tremors

Less common

Back pain

chest pain

constipation

heartburn

hot flushes

increased sweating

leg pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

It is very important that your doctor check your or your child's progress at regular visits to see if the medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Birth control pills containing estrogen may not work properly if you take them with topiramate. To keep from getting pregnant, use an additional form of birth control together with your birth control pill. If you have any questions about this, check with your doctor or pharmacist.

This medicine may cause vision changes, clumsiness or unsteadiness, dizziness, drowsiness, or trouble with thinking or speaking. Make sure you know how you or your child react to this medicine before you drive, use machines, climb in high places, swim, or do anything else that could be dangerous if you are not alert, well-coordinated, or able to think or see well.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, prescription pain medicines, or sleep medicines. Check with your doctor before taking any of these medicines while you or your child are using topiramate.

Check with your doctor immediately if you or your child have changes in vision or pain around the eyes during and after treatment with this medicine. Your doctor may want your eyes to be checked by an ophthalmologist (eye doctor).

This medicine may make you sweat less which will cause your body temperature to increase. Use extra care not to become overheated during exercise or hot weather with this medicine. Overheating may result in heat stroke and hot baths or saunas may make you dizzy or feel faint.

Topiramate may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor right away.

This medicine may cause nausea, muscle tremors, breathing problems, eating problems, fast heartbeats, restlessness, and abdominal or stomach pain. Tell your doctor right away if you or your child have any of these symptoms. You might have a serious condition called metabolic acidosis (too much acid in the blood).

This medicine may cause slow growth. For children, the doctor will need to keep track of height and weight to make sure that the child is growing properly.

Do not suddenly stop taking this medicine without checking first with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you or your child to gradually reduce the amount you are taking before stopping it completely.

Check with your doctor right away if you or your child are having unusual drowsiness, dullness, tiredness, weakness, feelings of sluggishness, mental depression or anxiety, nightmares or unusually vivid dreams, or vomiting. These may be symptoms of a serious condition called hyperammonemic encephalopathy.

Check with your doctor right away if you or your child have sudden back pain, abdominal or stomach pain, pain while urinating, or bloody or dark urine. These may be symptoms of kidney stones.

Tell your doctor if your or your child's skin feels like it is burning, crawling, itching, or if you have numbness, prickling, "pins and needles", or tingling feeling after using topiramate.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.