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Topamax

Generic: Topiramate

Rx only
Anticonvulsant✓ FDA-verified
View full FDA label ↗
Topamax is a medication used to treat epilepsy and prevent migraines. It works by stabilizing electrical activity in the brain and affecting certain chemicals that help control seizures and headaches. You can take it in tablet or sprinkle capsule form, usually starting at a low dose of 25 mg to 50 mg daily, and it can be increased to a maximum of 400 mg per day for epilepsy or 100 mg per day for migraine prevention. It's important to know that Topamax can cause serious allergic reactions, so if you have a history of hypersensitivity to it or its ingredients, you should avoid using it. Additionally, if you're taking other medications that affect your blood's ability to clot, like warfarin, be cautious, as Topamax may increase the risk of bleeding.
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Uses

  • Partial-onset seizures in patients 2 years and older.
  • Tonic-clonic seizures in patients 2 years and older.
  • Seizures associated with Lennox-Gastaut syndrome in patients 2 years and older.
  • Preventive treatment of migraine in patients 12 years and older.
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Dosage

Adults: 400 mg/day in two doses for monotherapy.
Pediatric patients 2 to 9 years: based on weight, starting at 25 mg/day.
Pediatric patients 10 years and older: 400 mg/day in two doses.
Elderly: dosage may need adjustment due to reduced renal function.
Renal impairment: half the usual adult dose recommended.
Always follow your doctor's specific instructions for your dose.
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Side effects

Common

paresthesiaweight lossanorexiadizzinessfatigueacute myopia

Serious

glaucomametabolic acidosissuicidal thoughtskidney stones
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Warnings

⚠ Important warnings

  • Increased risk of suicidal behavior and ideation.
  • Risk of metabolic acidosis and kidney stones.
  • May cause cognitive and neuropsychiatric issues.
  • Use caution with alcohol and CNS depressants.
  • Monitor for bleeding risks, especially with other medications.
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Drug interactions

  • Phenytoinmay decrease topiramate levelsCaution
  • Carbamazepinemay decrease topiramate levelsCaution
  • Valproic acidrisk of hypothermia and hyperammonemiaCaution
  • Hydrochlorothiazidemay increase topiramate levelsCaution
  • Lithiummonitor levels with high-dose topiramateMonitor

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Answers pulled from the FDA label only.

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Medical Disclaimer: This content is provided for informational and educational purposes only and is not intended as medical advice. Always consult a qualified healthcare provider before taking any medication.
Data Source: Publicly available drug labeling information from the U.S. Food and Drug Administration (FDA).