How to use Topamax (Topiramate) medicine

Why is this Topamax medication prescribed?

Topamax/Topiramate acts on the brain and nervous system. Topamax is used with other drugs to control various types of convulsions and seizures of epilepsy. Topamax/Topiramate works with your other medication to control seizures.

This Topamax medication is sometimes prescribed for other uses; ask your doctor or Topamax pharmacist for more Topamax information.

How should this Topamax medicine be used?

Topamax/Topiramate comes as a tablet to take by mouth. Topamax usually is taken twice a day. Topamax may be taken with or without food. Your doctor may adjust your Topamax dosage over the first few weeks, until your seizures are better controlled. Follow the Topamax directions on your Topamax prescription label carefully, and ask your doctor or Topamax pharmacist to explain any part you do not understand. Take Topamax/topiramate exactly as directed. Do not take more or less of Topamax or take Topamax more often than prescribed by your doctor.

Topamax/Topiramate controls epilepsy but does not cure it. Continue to take Topamax/topiramate even if you feel well. Do not stop taking Topamax/topiramate without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will decrease your Topamax dose gradually. This Topamax drug must be taken regularly for a few weeks before its full effect is felt.

Topamax/Topiramate has a bitter taste, so do not break or chew the tablet. If you cannot swallow the tablet, crush it, mix it with applesauce or oatmeal, and then eat it immediately.



Topamax therapy usually begins with a dose of 50 milligrams once daily during the first week. The daily dosage is then increased each week until, by the eighth week the patient is taking 200 milligrams twice a day.

For people with poor kidney function, the dosage is usually cut in half. On the other hand, those undergoing hemodialysis may need a supplemental dose.

If you are also taking Dilantin or Tegretol, the dosage of Topamax may need adjustment. Likewise, the doctor may adjust your dosage if you have liver problems.


The usual daily dose for children 2 to 16 years of age is 5 to 9 milligrams for every 2.2 pounds of body weight, divided into two doses. Topamax therapy usually begins with a dose of 25 milligrams (or less) once daily during the first week. The daily dosage is then increased each week until the doctor is satisfied with the patient’s response. It may take eight weeks to reach the ideal dose.

What special Topamax precautions should I follow?

Before taking Topamax/topiramate,

  • tell your doctor and Topamax pharmacist if you are allergic to Topamax/topiramate or any other drugs.
  • tell your doctor and Topamax pharmacist what prescription and nonprescription medications you are taking, especially other seizure medications, acetazolamide (Diamox), dichlorphenamide (Daranide), digoxin (Lanoxin), oral contraceptives, and vitamins. Do not drink alcoholic beverages or take sleeping pills, sedatives, or antihistamines while taking Topamax/topiramate.
  • tell your doctor if you have or have ever had kidney or liver disease or if you have ever had a kidney stone. If you have a history of kidney stones, drink six to eight (8-ounce) glasses of water every day to reduce the risk of kidney stone formation.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Topamax/topiramate, call your doctor.
  • Topamax/Topiramate may decrease the effectiveness of oral contraceptives; use another method of birth control. Call your doctor if bleeding or spotting occurs.
  • you should know that this Topamax drug may make you drowsy. Do not drive a car or operate machinery until you know how this Topamax drug affects you.
  • remember that alcohol can add to the drowsiness caused by this Topamax drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of Topamax/topiramate.

Topamax Side Effects

Although side effects from Topamax/topiramate are not common, they can occur. Tell your doctor if any of these Topamax symptoms are severe or do not go away:

  • drowsiness
  • nervousness
  • confusion
  • difficulty coordinating movements
  • tingling or numbness in the hands or feet

If you experience any of the following Topamax side effects, call your doctor immediately:

  • blurred or double vision
  • eye pain
  • eye redness

What storage conditions are needed for Topamax?

Keep Topamax in the container it came in, tightly closed and out of reach of children. Store Topamax at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any Topamax medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your Topamax medication.

Other uses for this Topamax medicine

This Topamax medication may be prescribed for other uses; ask your doctor or pharmacist for more Topamax information.

What should I do if I forget a Topamax dose?

Take the missed Topamax dose as soon as you remember it. However, if it is almost time for the next Topamax dose, skip the missed Topamax dose and continue your regular Topamax dosing schedule. Do not take a double Topamax dose to make up for a missed one.