What Is Topamax?

Generic Name: Topiramate

Brand Name: Topamax Sprinkle Capsules, Qudexy XR Sprinkle, Topamax, Trokendi XR

Introduction

Topamax is an anticonvulsant medicine, which is mostly used for the treatment of seizures, especially in adults and children who are more than 2 years old. Apart from treating convulsions, Topamax is also used to prevent instances of headaches due to migraines in adults as well as children who are above the age of 12.

However, it is important to note that this medicine cannot relieve headaches once they have already begun. It is only used to prevent or reduce the number of migraine attacks in an individual. Topamax can also be used in treating other medical conditions, but its safety and effectiveness are still not clearly established. Thus, its uses for other conditions are not yet approved by the FDA.

Before Usage

• Let the doctor know if you are pregnant or planning for a pregnancy since Topamax may harm an unborn baby. 
• Do not all of a sudden start or stop taking Topamax without a doctor's advice.
• Even if you feel that the symptoms are improving or if you feel better, do not stop taking the medicine. Continue to take it and complete the course of treatment as recommended by the doctor.
• If there is a sudden change in your vision or when you experience pain around or behind the area of your eyes, reach out to the doctor immediately since it could be an early symptom of permanent vision damage.
• If the individual suddenly stops taking Topamax, then it can result in more seizure attacks. The medicine should be gradually stopped over a period of time under the guidance of a doctor.
• Inform the doctor if seizure attacks tend to worsen during the course of Topamax treatment. 

To ensure that this medicine is completely safe for you, let the doctor know if you have any of the following medical conditions:

• Eye-related problems or glaucoma
• A past history of depression
• Kidney disease
• Any history of kidney stones
• Suicidal thoughts
• Diabetes
• Mood-related issues
• If you currently consume lithium
• Soft and brittle bones leading to osteoporosis or osteomalacia
• Currently on dialysis
• History of metabolic acidosis
• Diarrhea

Taking this medication can lead to excessive sweating, which increases the risk of heatstroke. Thus, avoid doing anything, which would lead to overheating.

Precautions

During the course of Topamax treatment, patients may have suicidal thoughts. Thus, the doctor would need to keep a regular watch on the progress of the individual. Family members and friends should also be aware of the patient's condition. They can also keep a watch when it comes to the patient's mood changes and other worsening symptoms. Although rare, Topamax may also cause metabolic problems such as increased levels of ammonia in the blood, especially when patients are also taking valproic acid. Since Topamax can cause metabolic acidosis, it may also lead to the weakening of bones, serious kidney stones, harm an unborn child, or may cause growth and development problems in children. 

To make sure that patients do not have metabolic acidosis, certain blood tests may be needed, especially in pregnant women. Taking Topamax during pregnancy can also lead to an increased risk of having a child with low birth weight, cleft lip, and cleft palate.

Taking Topamax along with birth control pills would make the pills less effective. Thus, it is advisable to use a barrier method of birth control such as condoms or a diaphragm to prevent pregnancy. Inform the doctor right away if you get pregnant during the course of treatment.

A ketogenic diet is high in fat but low in carbohydrates, which may lead to an increased risk of getting kidney stones. For this reason, it is better to avoid consuming a ketogenic diet during Topamax treatment. When alcohol is combined with Topamax, it can cause dangerous side effects such as an increase in seizure attacks. Patients are often advised not to consume alcohol during Topamax treatment. 

Avoid getting overheated or dehydrated, especially when the weather is sunny or hot. Taking Topamax may lead to sweat reduction and an increase in body temperature, which may lead to dehydration. However, take note that these side effects can also get worse if you take other medications such as:

• Medications for Parkinson’s disease
• Cold or allergy medicine
• Medicine used for bladder or urinary problems
• Bronchodilators
• Drugs used for the treatment of stomach ulcers 
• Medications for irritable bowel syndrome

Do not drive or operate machinery after taking this medication. Topamax may cause vision problems and tends to impair thinking and reactions. 

On the safe side, do not carry out any activity that would require focus and mental alertness. Avoid carrying out any activities that would involve climbing, trekking to high places, or swimming since Topamax may cause unexpected seizures. 

Usage 

Take Topamax exactly as prescribed by the doctor. You can also check the label of the medicine for more detailed instructions about the drug's usage and dosage. The doctor can make dosage adjustments according to the patient's  response to the treatment.

Avoid taking a larger or smaller dose of this medicine or taking more than the drug's recommended dose without a doctor's advice. Topamax can be taken with or without food. Swallow the tablet as a whole and do not crush, chew, or break it.

There are also Topamax sprinkle capsules available, which can be swallowed as a whole. You can also open the capsule and sprinkle the medicine into a spoon filled with any soft food such as applesauce. Once it is mixed properly, swallow the mixture right away. Avoid storing it for later use. 

While taking this medicine, drink plenty of fluids to prevent kidney stones from forming or have an electrolyte imbalance. Store this medicine at room temperature and away from light, heat, and moisture.

If you missed a dose, then take it as soon as you remember. However, if it is almost time for the next dose, then skip the missed one and follow the regular dosing schedule. Do not take an extra dose to make up for the missed dose to avoid overdosing.

The symptoms of an overdose include:

• Agitation
• Double vision
• Thinking problems 
• Speech problems
• A lack of coordination
• Signs of depression
• Increased frequency of convulsions
• Fainting

Dosage

The dose is completely based on the medical condition and the body's response to the given treatment. In the case of children, the dosage is usually based on the weight of the child. The dosage also depends on the patient's age, the severity of the medical condition, and other medical conditions.

The dose can be gradually increased to reduce the risk of having side effects. In certain conditions, treatment with Topamax can be taken once a day before bedtime and can be gradually increased to two times a day. It would take around several weeks or months to reach the best dose and get complete benefit from the treatment. Make sure to complete the course of treatment and try to take the medicine daily at the same time.

Side Effects

Below are some of the common side effects that come along with Topamax:

• Certain changes in the taste
• Flushing 
• Warmth or tingling sensations in the arms and legs
• Numbness
• Dizziness
• Vision or speech problems
• Symptoms related to colds such as sneezing, stuffy nose, or a sore throat
• Mood changes
• Fatigue or weakness
• Impaired memory or thinking leading to poor decision making
• Slow reaction to any situation
• Drowsiness
• Diarrhea
• Pain in the stomach
• Loss of appetite
• Nausea
• Digestive problems
• Loss of weight

These common side effects are usually mild and would go away within a couple of days or weeks. However, seek immediate medical attention if the side effects tend to worsen or stay for a longer duration.

If there are any signs of an allergic reaction such as finding it difficult to breathe, hives, swelling of the lips, face, throat, and tongue, then get emergency help right away. If there are new symptoms or worsening of mood symptoms, inform the doctor of the same. Some of the symptoms would include:

• Anxiety
• Trouble sleeping
• Feeling impulsive
• Hostile nature
• Mood troubles
• Changes in behavior 
• Easily irritated
• Suicidal thoughts
• Tendency to hurt oneself
• Hyperactive both physically and mentally
• Depression
• Restlessness

Below are the serious form of side effects, which should be brought to the doctor’s attention before it becomes fatal:

• Vision problems
• Redness or pain in the eye
• Loss of vision all of a sudden
• Sudden changes in body temperature that leads to dehydration (high fever, hot and dry skin, and reduced sweating)
• Slow thinking 
• Feeling confused
• Poor concentration
• Speech and memory trouble 
• Pain at the side or the lower back, which may indicate kidney stones
• Difficult or painful urination
• Too much production of acid in the blood that leads to an irregular heartbeat, loss of appetite, shortness of breath, and weakness. 

If there is too much ammonia in the blood, it can lead to weakness, consistent vomiting, and a feeling that you may pass out anytime.

Drug Interactions

When certain medications are taken along with other types of medicine, drug interactions may occur. For this reason, it is important to inform your doctor if you have taken the following:

• Over-the-counter medicine
• Prescription drugs
• Herbal supplements
• Dietary supplements
• Certain vitamins

When Topamax is taken along with other medications, it may cause sleepiness and this side effect can worsen over time. Inform the doctor if you are taking any of the following medications:

• Sleeping pills
• Muscle relaxants
• Anxiolytics
• Narcotic pain medicine
• Antidepressants 
• Anticonvulsants

Inform the doctor about any medicine you are using and those which were started or stopped during the course of treatment with Topamax. Few of those medicines would include:

• Birth control pills
• Glaucoma medications such as acetazolamide or dichlorphenamide
• Metformin
• Anticonvulsants such as zonisamide, phenytoin, carbamazepine, divalproex sodium