Frequently Asked Questions
Some essential questions about TOPAMAX as a treatment for epilepsy are answered below.
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- How often do I take TOPAMAX?
- What happens if I skip a dose?
- Can I use TOPAMAX if I am taking other medicines?
- Are there treatments I should avoid when taking TOPAMAX?
- Are there foods, drinks, or activities I should avoid when taking TOPAMAX?
- What are the most common side effects when TOPAMAX is used in combination with other antiseizure medicines?
- What additional safety information should I know about?
- What should I do if I think I’m having a side effect?
- Should TOPAMAX be taken with food or on an empty stomach?
- If my seizures stop, how long will I have to keep taking TOPAMAX?
- How should TOPAMAX be stored?
- Is treatment support available for TOPAMAX users?
- I still have questions. Where can I get answers?
- How often do I take TOPAMAX?
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Follow your healthcare professional’s instructions. TOPAMAX is usually taken twice a day for epilepsy. Your healthcare professional will prescribe the dosage that’s right for you.
Set up a routine that works for you. Choose convenient times that fit into your daily routine, such as when you brush your teeth in the morning and at night. Some people use a medication check-off chart or an inexpensive container system to help them keep track.
Keep up with your routine. Even when your seizures are controlled, keep taking TOPAMAX as directed to help prevent them from occurring. Check with your healthcare professional if you have any questions about changing your treatment.
^ Return To Top - What happens if I skip a dose?
- It’s important to be consistent. Controlling your seizures can depend on taking
your medicine exactly as your healthcare professional has prescribed. Taking your medicine at the
same time every day helps keep a steady level of medicine in your bloodstream; missing a dose can
cause these levels to drop too low, allowing seizures to occur.
Ask your healthcare professional what to do if you miss a dose. Never try to "catch up" by taking twice your normal dose: this may release too much drug into your bloodstream and cause side effects. ^ Return To Top - Can I use TOPAMAX if I am taking other medicines?
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TOPAMAX can be used with most other medicines. This is good news—but you still need to pay careful attention to your medicines, and let your healthcare professional know what else you’re taking.
If you take hormonal contraceptives, tell your healthcare professional. The effectiveness of hormonal contraceptives (such as the Pill) may be reduced by certain antiseizure medicines, including some dosages of TOPAMAX. You should also tell the healthcare professional who prescribed the hormonal contraceptive that you are taking TOPAMAX.
If you take medicines that contain valproic acid, tell your healthcare professional. Using TOPAMAX and valproic acid at the same time has been linked to increased levels of ammonia in the blood, sometimes associated with vomiting and changes in alertness. Your healthcare professional will probably want to discontinue one of the medicines.
Tell your healthcare professional about any supplements you take. Before starting any new medicine, tell your healthcare professional about everything you are taking, including nonprescription drugs, food supplements, vitamins, or herbal products. Just because something is not prescribed by a healthcare professional does not mean it’s free of side effects and that it won’t affect other medicines.
Keep your healthcare professional informed of side effects. When people take antiseizure medicines, they sometimes experience side effects—such as dizziness, fatigue, or sleepiness. Side effects are most likely to appear when your body is just getting used to a new antiseizure medicine. Your healthcare professional can help guide you through this period and explain what you can do to reduce the impact of certain side effects.
^ Return To Top - Are there treatments I should avoid when taking TOPAMAX?
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Talk with your healthcare professional about any other medicines you take. Among the most important medicines to discuss are those that can cause kidney stones. Kidney stones have occurred in people taking TOPAMAX.
Let your healthcare professional know if you are on the ketogenic diet. Some children may be on the ketogenic diet—a special high-fat, low-carbohydrate diet that helps to control seizures. This diet can also cause kidney stones and should be discussed with your healthcare professional.
^ Return To Top - Are there foods, drinks, or activities I should avoid when taking TOPAMAX?
- There are no specific foods you need to avoid. Be sure to drink plenty of water to reduce the
risk of developing kidney stones and to prevent getting overheated during vigorous exercise or in
very warm settings.
Avoid alcohol. In general, people who have seizures should avoid alcohol. Alcohol can trigger seizures or make them more severe.
Stay active—but check with your healthcare professional first. Many people who experience seizures can lead physically active lives. Talk with your healthcare professional to see what activities are right for you. It’s especially important to get a healthcare professional’s advice before you engage in activities such as biking, skiing, skateboarding, or skydiving.
Don’t drive right away. Because of certain possible side effects, people on TOPAMAX are advised not to drive or operate machinery until they have gained enough experience on TOPAMAX to know whether it unfavorably affects their abilities. You will also need to meet the legal requirements of your state. Most states demand a seizure-free period before people with epilepsy can drive.
^ Return To Top - What are the most common side effects when TOPAMAX is used in combination with other antiseizure medicines?
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Side effects more commonly found in adults. When TOPAMAX is added to other antiseizure medicines, the most common side effects in adults are sleepiness, dizziness, coordination problems, speech disorders, a delay between thought and action called psychomotor slowing, abnormal vision (including double vision), difficulty with memory, and tingling sensations in the hands and feet. Women taking birth control pills along with TOPAMAX may experience increased breakthrough bleeding, and the birth control may not be as effective.
Side effects more commonly found in children. In children over the age of 2, taking TOPAMAX along with other antiseizure medicines, the most common side effects are sleepiness, loss of appetite, fatigue, nervousness, difficulty with concentration/attention, weight decrease, aggressive reaction, and difficulty with memory. In hot weather, children may experience decreased sweating, leading to an increase in body temperature. The safety and effectiveness of TOPAMAX in children younger than 2 years of age has not been established.
^ Return To Top - What additional safety information should I know about?
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Ask your healthcare professional if you have any concerns about this or any medication.
Serious risks associated with TOPAMAX include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis). Symptoms could include hyperventilation (rapid, deep breathing), tiredness, loss of appetite, irregular heartbeat or changes in the level of alertness. Call your doctor immediately if you get these symptoms. Your doctor may want to do simple blood tests. Chronic, untreated metabolic acidosis may increase the risk for kidney stones or bone disease.
Other serious risks include decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion, difficulty concentrating, and increased eye pressure (glaucoma). Call your doctor immediately if you have any decrease in vision or eye pain. These problems can lead to blindness if not treated right away.
More common side effects in adults are nervousness, coordination problems, fatigue, speech problems, slowed thinking, memory difficulty, tingling in arms and legs, and double vision; and in children, fatigue, loss of appetite, nervousness, memory difficulty, aggressive behavior, and weight loss.
As monotherapy, the most common side effects of TOPAMAX (in the 400 mg/day group and at a rate higher than the 50 mg/day group) in adults were tingling in arms and legs, weight decrease, sleepiness, loss of appetite, dizziness, and difficulty with memory; and in children, weight decrease, upper respiratory tract infection, tingling in arms and legs, loss of appetite, diarrhea, and mood problems.
In combination with other antiepileptic drugs (AEDs), the most common side effects of TOPAMAX in adults (200 to 400 mg/day) were sleepiness, dizziness, nervousness, loss of muscle coordination, fatigue, speech disorders and related problems, psychomotor slowing, abnormal vision, difficulty with memory, tingling in arms and legs, and double vision; and in children (5 to 9 mg/kg/day), fatigue, sleepiness, loss of appetite, nervousness, difficulty with concentration/attention, difficulty with memory, aggressive reaction, and weight decrease.
Tell your doctor about other medications you take.
Please see full U.S. Prescribing Information.
^ Return To Top - What should I do if I think I’m having a side effect?
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Discuss all side effects with your healthcare professional. Your healthcare professional has probably talked with you about the side effects that might occur. Some side effects that begin when you first start TOPAMAX may disappear on their own. However, if you have any questions or concerns about your medicine or if you’re feeling anything different from what your healthcare professional described, call your healthcare professional’s office.
Don’t assume you know the cause. Remember, the source of a side effect may not be as obvious as you might think. If you are taking TOPAMAX in addition to another antiseizure medicine, side effects may not be due to TOPAMAX. It may be the drug combination that is the cause.
Stay on track. The best way to reduce the chance of side effects is to follow your healthcare professional’s instructions carefully.
^ Return To Top - Should TOPAMAX be taken with food or on an empty stomach?
- TOPAMAX can be taken with or without food. Many people take their medicine at breakfast and dinner or when they brush their teeth. TOPAMAX is available in tablets or sprinkle capsules that may be opened and sprinkled onto food or swallowed whole. ^ Return To Top
- If my seizures stop, how long will I have to keep taking TOPAMAX?
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Ask your healthcare professional. Your healthcare professional is the best judge of how long treatment with TOPAMAX and other antiseizure medicines should continue. These drugs help to prevent seizures from occurring. Discontinuing therapy may make your seizures return.
Keep your goals in mind. You and your healthcare professional will only want to stop treatment when the risk of seizures is acceptably low. Remember, never stop taking your medicines without talking to your healthcare professional first. Abruptly stopping antiseizure medicine can trigger seizures in some patients.
^ Return To Top - How should TOPAMAX be stored?
- Keep your medicine in a safe place, away from extreme conditions. Store TOPAMAX tablets at room temperature (59°F to 86°F) in a tightly closed container, such as the prescription bottle the drugstore gave you; TOPAMAX sprinkle capsules should be kept at or below 77°F in a tightly closed container. All antiseizure medicines should be protected from moisture. Most importantly, keep your TOPAMAX in a convenient place that helps you remember to take it. As with any medication, keep out of the reach of children. ^ Return To Top
- Is treatment support available for TOPAMAX users?
- Yes, it is. To learn more about epilepsy and therapy with TOPAMAX, join Everyday Essentials™, a FREE information-and-support program just for people who are taking TOPAMAX and their loved ones. ^ Return To Top
- I still have questions. Where can I get answers?
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Your healthcare professional should be your primary source for all medical questions. For practical answers on living with epilepsy, get in touch with other people who are living with epilepsy, and learn about what has worked for them. Online communities and local organizations are a good place to start. Please see our Important Organizations and Resources page for more.
If you are still having seizures while taking an antiseizure medicine, your healthcare professional may choose to add TOPAMAX to your treatment.
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