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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. Epilepsy is a chronic disorder that is responsible for causing unprovoked, recurrent seizures in the body. A seizure is a sudden attack in the brain that makes a person lose control of their actions. Migraine is a mental condition that often causes intense or debilitating headaches with difficulty speaking, nausea, vomiting, and sensitivity to light or sound.

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 relieves the symptoms of migraine.

Take Topiramate exactly as prescribed. Your doctor will determine the dosage and timing of Topiramate based on the severity of your medical condition. 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. 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.

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. Inform your doctor if you have ever had glaucoma (increased eye pressure), metabolic acidosis (excess acid in the blood), diarrhoea, suicidal thoughts, bone disorders, acute porphyria (a blood disorder), or lung, liver, or kidney problems. Topiramate is not recommended during pregnancy, as it may increase the risk of birth defects 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.

Uses of Topiramate

Topiramate is used in the treatment of epilepsy (seizures/fits) and for the prevention of migraine. The detailed uses of Topiramate are as follows:
• 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 is an antiepileptic/anticonvulsant medication primarily used to treat epilepsy, either as monotherapy or adjunctive therapy. In monotherapy for epilepsy, Topiramate is recommended for patients above 2 years of age with partial-onset (focal) or primary generalized tonic-clonic (full-body) seizures. In adjunctive therapy for epilepsy, Topiramate is recommended for patients over 2 years of age with partial seizures, tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome (a type of childhood epilepsy). Topiramate is also used to prevent migraine headaches. Topiramate works by blocking the voltage-dependent sodium and calcium channels and increasing the inhibitory actions of a brain chemical called GABA (gamma-aminobutyric acid). In epilepsy, Topiramate helps control the electrical activity of nerves in the brain, thereby preventing or controlling seizures. While in migraine, Topiramate calms the overactive nerve cells in the brain that are responsible for triggering migraine attacks.

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

Store in a cool and dry place away from sunlight

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.

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:

  • PHENYTOIN
  • CARBAMAZEPINE
  • VALPROIC ACID
  • LAMOTRIGINE
  • DIGOXIN
  • ST JOHN'S WORT
  • DILTIAZEM
  • HYDROCHLOROTHIAZIDE
  • METFORMIN
  • GLIBENCLAMIDE
  • RISPERIDONE
  • WARFARIN
  • Safety Advice

    • Safety Warning

      Alcohol

      caution

      Avoid consuming alcohol while taking Topiramate, as it may worsen the side effects like dizziness and drowsiness.

    • Safety Warning

      Pregnancy

      unsafe

      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.

    • Safety Warning

      Breast Feeding

      caution

      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.

    • Safety Warning

      Driving

      caution

      Topiramate may impair your vision, thinking, and motor skills; therefore, do not drive or operate machines until you know how this medication affects you.

    • Safety Warning

      Liver

      consult your doctor

      Topiramate 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.

    • Safety Warning

      Kidney

      consult your doctor

      Topiramate should be used with caution in patients with kidney disease, as the dosage may need to be adjusted in patients with kidney impairment.

    • Safety Warning

      Children

      safe if prescribed

      Topiramate is safe to use in children above 2 years only if prescribed by the doctor.

    Habit Forming

    No

    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, characterized 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 generalized seizure. Sometimes, a person starts experiencing the symptoms before starting of seizure that includes 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, characterized 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.

    Available Medicines for

    Topiramate

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