Topiramate
About Topiramate
Topiramate belongs to a group of medications called antiepileptics/anticonvulsants, primarily used to treat epilepsy (seizures/fits). It is also used in the prevention of migraine headaches.
Topiramate contains Topiramate, which works by restoring the balance of neural activity and reducing the spread of seizure activity in the brain. By controlling the electrical activity of the brain, Topiramate helps control seizures and relieve the symptoms of migraine.
You may experience common side effects, such as dizziness, drowsiness, loss of appetite, nausea, tiredness, confusion, cognitive impairment, fever, flushing, and tingling in the legs and arms. If any of these side effects persist or worsen, please consult your doctor.
Before taking Topiramate, inform your doctor if you are allergic to any of its ingredients. Do not stop taking Topiramate without consulting your doctor, as sudden withdrawal may lead to uncontrolled seizures.
Uses of Topiramate
• Monotherapy for Epilepsy: Topiramate is used alone in adults and children over 2 years who have specific types of seizures, like partial (focal) seizures or tonic-clonic (full-body) seizures.
• Adjunctive Therapy for Epilepsy: Topiramate is also used in combination with other seizure medications in adults and children over 2 years to treat partial seizures, tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome (a type of childhood epilepsy).
• Preventive Therapy for Migraine: Topiramate helps prevent migraine headaches in adults and children over 12 years, but it does not treat acute migraine attacks once it has started.
Medicinal Benefits
- Topiramate belongs to the class of medicines called antiepileptics/anticonvulsants. It is primarily used to treat epilepsy and prevent migraine headaches.
- In epilepsy, Topiramate helps control and prevent different types of seizures, including partial-onset (focal) seizures, primary generalised tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.
- It works by reducing the abnormal electrical activity in the brain, thereby preventing the occurrence of seizures.
- In migraine, Topiramate helps reduce the frequency and severity of migraine attacks by calming overactive nerve cells in the brain.
- Topiramate stabilises brain activity by blocking voltage-dependent sodium and calcium channels and enhancing the action of gamma-aminobutyric acid (GABA), a natural chemical that prevents excessive nerve stimulation.
- Topiramate has appetite-suppressing properties, making it suitable for weight loss under medical supervision.
Directions for Use
- Topiramate can be taken with or without food.
- It is usually taken 1-2 times daily; however, your doctor may adjust the dose based on your medical condition.
- Swallow Topiramate as a whole with a glass of water.
- Do not crush or chew this medication.
Storage
Side Effects of Topiramate
- Dizziness
- Somnolence (drowsiness)
- Anorexia (loss of appetite)
- Weight loss
- Nausea
- Diarrhoea
- Fatigue (tiredness)
- Difficulty with memory and concentration
- Confusion
- Cognitive impairment
- Infection
- Fever
- Flushing (a feeling of warmth)
- Paraesthesia (tingling of the legs and arms)
Drug Warnings
- Do not take Topiramate if you are allergic to any of its ingredients.
- Inform your doctor if you have ever had kidney problems (such as kidney stones or undergone dialysis), glaucoma (increased eye pressure), metabolic acidosis (excess acid in the blood), growth problems, breathing problems, diarrhoea, suicidal thoughts, mood disturbances, bone disorders (such as osteoporosis or osteomalacia), liver disease, or a blood disorder (such as acute porphyria).
- Do not stop taking Topiramate without consulting your doctor, as sudden withdrawal may lead to uncontrolled seizures.
- Topiramate is not recommended during pregnancy, as it may increase the risk of birth defects (like cleft palate and cleft lip) in the unborn baby.
- Topiramate may pass into breast milk, so consult your doctor to determine whether it is safe to breastfeed while taking Topiramate.
- If your baby is unusually sleepy, feeds poorly, or has diarrhoea, consult your doctor promptly.
- Avoid consuming alcohol while taking Topiramate, as it may worsen the side effects like dizziness and drowsiness.
- Topiramate may impair your vision, thinking, and motor skills; therefore, do not drive or operate machines until you know how this medication affects you.
- Let your doctor know if you are taking any other medicines or have pre-existing medical conditions.
Drug Interactions
Drug-Drug Interaction: Topiramate may interact with other anticonvulsants (phenytoin, carbamazepine, valproic acid, lamotrigine), drugs used to treat heart failure (digoxin), herbal supplements for depression (St John's Wort), blood pressure medications (diltiazem, hydrochlorothiazide), medicines used to treat diabetes (metformin, glibenclamide), antipsychotics (risperidone), blood thinners (warfarin), and hormonal contraceptives (such as pills, implants, rings, patches, or injections).
Drug-Food Interaction: Avoid consuming alcohol while taking Topiramate, as it may worsen the side effects like dizziness and drowsiness.
Drug-Disease Interaction: Inform your doctor if you have ever had kidney problems (such as kidney stones or undergone dialysis), glaucoma (increased eye pressure), metabolic acidosis (excess acid in the blood), growth problems, breathing problems, diarrhoea, suicidal thoughts, mood disturbances, bone disorders (such as osteoporosis or osteomalacia), liver disease, or a blood disorder (such as acute porphyria).
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionAvoid consuming alcohol while taking Topiramate, as it may worsen the side effects like dizziness and drowsiness.
Pregnancy
unsafeTopiramate is not recommended during pregnancy, as it may increase the risk of birth defects (like cleft palate and cleft lip) in the unborn baby.
Breast Feeding
cautionTopiramate may pass into breast milk, so consult your doctor to determine whether it is safe to breastfeed while taking Topiramate. If your baby is unusually sleepy, feeds poorly, or has diarrhoea, consult your doctor promptly.
Driving
cautionTopiramate may impair your vision, thinking, and motor skills; therefore, do not drive or operate machines until you know how this medication affects you.
Liver
consult your doctorTopiramate should be used with caution in patients with liver disease, as impaired liver function may reduce the medication's clearance. Therefore, the dosage may need to be reduced in patients with liver disease.
Kidney
consult your doctorTopiramate should be used with caution in patients with kidney disease, as the dosage may need to be adjusted in patients with kidney impairment.
Children
safe if prescribedTopiramate is safe to use in children above 2 years only if prescribed by the doctor.
Habit Forming
Diet & Lifestyle Advise
- Eat a balanced diet that consists of good fats, proteins, carbohydrates, vegetables, and fruit, which helps the body and brain work properly and keeps a person healthy and energetic.
- Fatigue is one of the primary reasons that trigger seizures in the body, so sleeping properly can help relax the brain.
- One should avoid the consumption of alcohol as it can trigger seizures in patients. Even one or two glasses can trigger epilepsy and worsen the side effects of Topiramate.
- Maintain your happiness and avoid taking emotional stress, as it can trigger seizures. People who maintain healthy stress levels have reported that they have responded well to the medicine.
Special Advise
- Topiramate may increase the body temperature and reduce sweating. Inform our doctor immediately if you experience decreased sweating along with hot, dry skin.
- Inform your doctor if you are using any contraceptives to prevent pregnancy, as Topiramate may reduce the effectiveness of hormonal contraceptives (such as pills, implants, rings, patches, or injections).
- Avoid a ketogenic diet or any high-fat, low-carb diet while taking Topiramate.
Patients Concern
Disease/Condition Glossary
Epilepsy: It is a neurological disorder in which brain activity becomes abnormal, characterised by intense electrical bursts in the brain (seizures). When these bursts happen in one part of the brain, it is called a partial seizure, while if these bursts occur in the entire brain, it is called a generalised seizure. Sometimes, a person starts experiencing the symptoms before the onset of a seizure, which include a sudden feeling of fear, dizziness, changes in vision, shakiness in arms and legs, and a headache. The symptoms that occur during a seizure include losing consciousness, characterised by confusion, uncontrollable muscle spasms, falling, biting tongue, rapid eye movements, unusual noises, or sudden mood changes.
Migraine: It is a mild to severe headache that starts as a dull ache in the region around the eye. It usually lasts a few hours up to several days and gets worse with movement. The possible warning signs that can start before the occurrence of migraine include visual changes, unusual tiredness, and tingling in an arm or leg. A person facing migraine may also face mild to severe pain in the head, pulsing, throbbing pain in the head, sensitivity to sound and light, vomiting, and Nausea.
FAQs
Topiramate is an anticonvulsant medication primarily used in the treatment of epilepsy (seizures/fits). It is also used in the prevention of migraine.
Topiramate works by restoring the balance of neural activity and reducing the spread of seizure activity in the brain. By controlling the electrical activity of the brain, Topiramate helps control seizures.
No, you should take rest after taking Topiramate. Topiramate may impair your vision, thinking, and motor skills, so avoid doing any task that requires mental alertness.
Topiramate acts by decreasing the spread of seizure activity in the brain. It also restores the normal balance of neurons, which in turn calms the brain. In epilepsy, cells present in the brain talk to each other by generating electric signals. When these cells fail to work properly or work faster than normal then it causes seizures. Topiramate slows down these electrical signals, thereby preventing or controlling seizures. While in migraine, Topiramate calms the overactive nerve cells in the brain that are responsible for triggering migraine attacks.
Yes, the use of Topiramate is safe for long-term use if suggested by the doctor.
Yes, Topiramate may affect the working of contraceptives that include the combined pill, vaginal ring, patches, progestogen-only contraceptive pill, and emergency contraception. Tell your doctor if you are using any type of contraceptives, as they may suggest using different types of contraceptives or combined hormonal contraceptives.
Generally, one should avoid consuming alcohol while taking Topiramate as it may make a person feel sleepy or tired and can cause seizures in some people with epilepsy.
Yes, studies have shown that Topiramate can cause hair loss (alopecia), but it is not a common side effect. If this happens, please consult your doctor and seek appropriate treatment.
Feeling sleepy is one of the most common side effects of Topiramate. It does not require medical attention, is usually mild and goes away over time. Consult the doctor if any of these side effects continue or worsen with time.
Do not stop taking Topiramate abruptly unless your doctor instructs you to. If you're using it to prevent migraines, your condition may worsen temporarily after you stop taking it. If you are using Topiramate for epilepsy, you may get seizures when you stop taking it. To prevent these withdrawal symptoms, your doctor may gradually reduce the dose of your Topiramate if required.
Take Topiramate for as long as prescribed by your doctor. The duration of treatment with Topiramate depends on the medical condition you are being treated for and your response to the treatment.
No, Topiramate is not intended to treat anxiety. It is mainly indicated for seizures.
The severe side effects caused by Topiramate include signs of glaucoma (blurred vision, difficulty seeing, and eye pain), kidney stones and a kidney infection (pain in your back, belly, or side, a burning sensation when you pee, or cloudy or smelly pee), metabolic acidosis (feeling sleepy, losing your appetite, and having an irregular heartbeat), and not sweating (especially in children). If this happens, consult your doctor immediately and seek medical attention.
Taking valproic acid when you are also taking Topiramate can cause your body temperature to drop to less than 95°F or 350C or cause tiredness, confusion, or coma. Taking these medicines may also raise the levels of ammonia in your blood. So, do not take these medications together. If you are required to, your doctor may guide you in taking them appropriately.
Topiramate is safe for children above two years of age only if prescribed by the doctor.
Weight loss and loss of appetite (anorexia) were two of the most commonly reported side effects. If you experience significant changes, seek medical advice from your healthcare professional.
The common side effects of Topiramate include dizziness, drowsiness, loss of appetite, nausea, tiredness, confusion, cognitive impairment, fever, flushing, and tingling in the legs and arms. Most of these side effects do not require medical attention and will gradually resolve on their own. If any of these side effects persist or worsen, please consult your doctor.
Topiramate may be used for weight management. However, this is an off-label use and it should be used for weight management only if advised by your doctor.
