It’s a prescription medication that’s used in adults and some children to:
- treat certain types of seizures
- help prevent migraine headaches
To learn more about topiramate’s uses, see the “What is topiramate oral tablet used for?” section below.
Topiramate oral tablet basics
You’ll take topiramate oral tablets by mouth.
Topiramate oral tablets are immediate-release tablets. This means their active ingredient gets released into your body shortly after you swallow them.
Topiramate also comes in other forms that are all taken by mouth. These forms include:
- immediate-release sprinkle capsules
- extended-release sprinkle capsules
- extended-release capsules
Sprinkle capsules are designed to be used by people who have trouble swallowing. The contents of these capsules can be easily sprinkled on foods or in drinks.
Extended-release forms slowly release their active ingredient over a longer period of time than immediate-release forms do.
This article only describes topiramate oral tablets. If you’d like to learn about topiramate’s other forms, talk with your doctor or pharmacist.
Topiramate oral tablet brand-name versions
In general, generic drugs usually cost less than brand-name drugs.
Note: The other forms of topiramate, besides oral tablets, have other brand-name versions. To learn about those other versions, talk with your doctor or pharmacist.
Topiramate is a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that topiramate oral tablets are based on is called Topamax.
Generic drugs are thought to be as safe and effective as the brand-name drug they’re based on. In general, generics usually cost less than brand-name drugs do.
If you’d like to know more about using Topamax instead of topiramate oral tablets, talk with your doctor. Read this Healthline article to learn more about the differences between generic and brand-name drugs.
Like most drugs, topiramate oral tablets may cause mild and serious side effects. The lists below describe some of the more common side effects that topiramate oral tablets may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you may be taking
Your doctor or pharmacist can tell you more about the potential side effects of topiramate oral tablets. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that topiramate oral tablets can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read topiramate oral tablet’s prescribing information.
- tingling in your arms and legs
- reduced appetite
- weight loss
- changes in taste
- problems with speaking
- trouble with your memory
- fatigue (lack of energy)
- slowed reactions
- reduced sensitivity to touch on your skin
- belly pain
- upper respiratory tract infection, such as the common cold
- hair loss*
Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* For more information about this side effect, see the “Side effect focus” section below.
Serious side effects
Serious side effects from topiramate oral tablets can occur, but they aren’t common. If you have serious side effects from topiramate oral tablets, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of topiramate oral tablet that have been reported include:
- increased acid level in your blood
- increased ammonia level in your blood
- decreased sweating that can lead to fever
- problems with thinking, memory, attention, and reaction
- suicidal thoughts or actions
- severe skin reactions, which may cause blistering and peeling skin
- kidney stones*
- eye or vision problems*
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Side effect focus
Learn more about some of the side effects topiramate oral tablet may cause.
Hair loss wasn’t a common side effect of topiramate oral tablets in studies. But hair loss occurred in more people who took a higher dosage of the drug compared with those who took a lower dosage.
If you’re taking topiramate for certain seizure disorders, your doctor may prescribe other medications that also treat your condition. These medications usually include other antiepileptic drugs (AEDs). And many AEDs can cause hair loss as a common side effect.
One older report described someone who had hair loss after taking topiramate for 2 months. But they were also taking other AEDs to treat their seizure disorder. The report stated that their hair loss stopped after treatment was discontinued.
As with any treatment, you shouldn’t stop taking topiramate without first talking with your doctor.
What might help
Here are a few tips that may help manage or lessen hair loss from topiramate oral tablets:
- Be sure to eat foods that are packed with nutrients that your body needs for hair growth. Some examples of the best foods for hair growth include eggs, berries, nuts, fish, beans, and avocados.
- Avoid harsh hair treatments and styling. Keep in mind that chemical processes such as perms and color treatments can contribute to hair loss. Also, keeping your hair pulled back into tight styles can result in hair breakage.
- Consider taking vitamin or mineral supplements. Hair loss can be a sign that you’re deficient in certain vitamins or minerals. There’s some evidence that vitamins A, B, C, D, as well as iron, selenium, and zinc can promote hair growth. But check with your doctor before taking vitamins or supplements to help with hair growth.
- Think about trying stress-reduction techniques such as exercise, aromatherapy, or meditation. This is because high stress levels can contribute to hair loss.
If you’re concerned about hair loss with topiramate, talk with your doctor. They may recommend changes to your treatment plan.
Taking topiramate can increase your risk for kidney stones. Overall, kidney stones were a less common side effect in studies of the drug. But the risk of kidney stones was higher in males taking topiramate than in females taking it.*
Your risk for kidney stones with topiramate may also be higher if you take certain other medications. This risk can also be increased if you follow a ketogenic diet. (A ketogenic diet is high in fat and low in carbohydrates.)
Symptoms of kidney stones may include:
- severe pain in your back or side
- frequent or painful urination
- pink, red, or dark urine
- nausea or vomiting
* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
What might help
Increasing your fluid intake and making some changes in your diet may help reduce your risk for kidney stones.
Staying hydrated with plenty of fluids is one of the best ways to help prevent or reduce kidney stone formation. Consider drinking at least 3 quarts (ten 10-ounce glasses) of liquid per day. This is especially important if you’ve had a kidney stone in the past.
Some people have trouble drinking a lot of water. If it’s tough for you too, try these tips:
- Add refreshing flavor to your water with cucumber slices or drops of food-safe peppermint oil.
- Consider getting an insulated water bottle that keeps your water cold for hours.
- Use a smartphone app that reminds you to drink water and helps you track your water intake.
- Eat raw fruits and vegetables. These items can contain a lot of water and add to your total fluid intake. Try adding a fresh salad to your daily routine.
Also, eating citrus fruits such as oranges or adding lemon to your water may help prevent kidney stones. The citric acid found in these fruits may help to prevent stones from forming.
It may also help to cut down on foods with high salt content. This includes processed foods such as chips, crackers, most frozen foods, and canned soups.
If you’re concerned about kidney stones with topiramate treatment, talk with your doctor. They can help guide you on the best ways to lower your risk for kidney stones. And be sure to call your doctor if you have any symptoms of kidney stones while you’re taking this drug.
Eye or vision problems
Eye or vision problems can be mild or serious side effects of topiramate.
Less commonly, serious eye or vision side effects have happened with topiramate oral tablets. Serious eye problems with topiramate may include:
- a sudden decrease in your ability to see at a distance, with or without eye pain and redness
- a blockage of fluid in your eye, which can lead to increased pressure in the eye (a condition called secondary angle glaucoma)
According to reports, serious vision problems with topiramate most often occurred within the first month of treatment.
If these serious eye problems aren’t treated, permanent vision loss may occur.
What might help
If you have any changes in your vision during topiramate treatment, call your doctor or get medical care right away. The serious vision problems described above require treatment as soon as possible. If they’re not treated right away, your vision could be permanently damaged or lost.
If you have questions about eye or vision side effects while you’re taking topiramate, talk with your doctor or pharmacist.
Symptoms of a mild allergic reaction can include:
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to topiramate oral tablets. But if you think you’re having a medical emergency, call 911 or your local emergency number.
It’s a prescription medication that’s used in adults and some children to:
- treat certain types of seizures
- help prevent migraine headaches
Topiramate for seizures
Topiramate is used to treat certain types of seizures in adults and children ages 2 years and older. These types of seizures include:
- Partial onset seizures. Also called a focal onset seizure, this is a seizure that begins in one half of your brain. During a partial onset seizure, you may be aware of what’s happened, or you may lose consciousness (pass out).
- Generalized tonic-clonic seizures. This type of generalized onset seizure involves both sides of your brain. “Tonic” describes sudden muscle stiffness that happens, and “clonic” refers to repeated jerking movements that occur. With a generalized tonic-clonic seizure, you’ll lose consciousness and you likely won’t remember the seizure afterward.
- Seizures related to Lennox-Gastaut syndrome. Lennox-Gastaut syndrome is a rare but severe condition that can affect young children.
A seizure is a burst of uncontrolled electrical signals between brain cells. It causes temporary but abnormal changes in your muscle movements, sensations, or level of awareness.
To treat partial onset and generalized tonic-clonic seizures, topiramate can be used by itself or in combination with other drugs. For seizures related to Lennox-Gastaut syndrome, topiramate treatment is only approved in combination with other drugs.
If excessive or inappropriate signals are sent in your brain, they could lead to seizures. Topiramate works by helping prevent your nerve cells from sending these inappropriate signals.
Topiramate for migraine headaches
Topiramate is used to help prevent migraine headaches in adults and children ages 12 years and older.
A migraine headache isn’t the same thing as a severe headache. Migraine is a neurological condition that causes multiple symptoms. Symptoms may include:
- intense headache
- sensitivity to light and sound
Topiramate doesn’t treat migraine headaches while they’re happening. Instead, it only helps to prevent them from occurring.
If excessive or inappropriate signals are sent in your brain, they could lead to migraine headache. Topiramate works by helping prevent your nerve cells from sending these inappropriate signals.
Find answers to some commonly asked questions about topiramate oral tablets.
Is topiramate used for weight loss? If so, how do you take it and what’s the dosage?
Topiramate oral tablets aren’t approved for use as a weight-loss drug. But some people lose weight as a common side effect of topiramate.
For more information on the approved uses and dosages of topiramate oral tablets, talk with your doctor.
Is topiramate used with phentermine?
Topiramate oral tablets are sometimes used together with phentermine for weight loss. But this is an off-label use for topiramate. (With off-label use, a drug that’s approved for certain conditions is used for another purpose.)
Topiramate oral tablets aren’t approved for weight loss. And they don’t contain phentermine.
A brand-name prescription medication called Qsymia contains both phentermine and extended-release topiramate. But keep in mind that topiramate oral tablets contain immediate-release topiramate. (Extended-release forms slowly release their active ingredient over a longer period of time than immediate-release forms do.)
For more information about phentermine or Qsymia, talk with your doctor.
Is topiramate used to treat bipolar disorder, anxiety, or pain?
Bipolar disorder is usually treated with drugs known as mood stabilizers. Topiramate isn’t a mood stabilizer. Instead, it’s considered an antiepileptic drug.
If you’d like more information about off-label uses for topiramate, talk with your doctor.
How does topiramate work? And what’s its half-life?
Topiramate works inside your brain. Its mechanism of action is to interfere with signals that your brain cells use to communicate with the rest of your body.
The average half-life of topiramate oral tablets is around 21 hours. (A drug’s half-life is the time needed for half of a dose of a drug to be cleared from your body.)
It generally takes five half-lives for a drug to be fully cleared out of your system. So, topiramate oral tablets will be cleared from your body about 5 days after you stop taking them.
Does stopping topiramate cause withdrawal?
Stopping topiramate suddenly could also increase your risk for seizures, even if you haven’t had a seizure before.
Before stopping this drug, first talk with your doctor to decide whether you should stop taking it.
Your doctor may give instructions to you on how to gradually reduce your dose before stopping the drug altogether. They may also recommend a different medication to replace topiramate, depending on your condition.
Is topiramate a controlled substance? Will it make me feel ‘high’?
No, topiramate isn’t a controlled substance. And it isn’t known to cause a “high” feeling like some controlled drugs do.
The use of controlled drugs is regulated by the federal government. These drugs carry a higher risk of misuse or dependence than other drugs do. (With misuse, a drug is taken in way other than how it’s prescribed. And with dependence, your body needs the drug in order for you to feel normal.)
Your doctor will explain how you should take topiramate oral tablets. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Taking topiramate oral tablet
You’ll take topiramate oral tablets by mouth. (Topiramate also comes in other forms. For more information, see the “What is topiramate oral tablet?” section above.)
Topiramate oral tablets are immediate-release tablets. This means their active drug gets released into your body shortly after you swallow them.
The dosage of topiramate that your doctor prescribes for you depends on:
- your age
- your body weight, in children taking the drug
- the reason you’re taking topiramate
- any other medications you’re taking
- any other health conditions you may have
Your doctor will likely start you taking a low dosage of topiramate. Then, they’ll slowly increase it over time, until they find the lowest dosage that’s effective for your condition.
If you have questions about your dosage of topiramate oral tablets, talk with your doctor or pharmacist.
Taking topiramate oral tablet with other drugs
To treat certain types of seizures, topiramate oral tablet is used in combination with other medications that treat seizures. These drugs belong to a group of medications called antiepileptic drugs (AEDs).
Some examples of other commonly prescribed AEDs include:
- carbamazepine (Tegretol, Carbatrol, Epitol, Equetro)
- divalproex (Depakote)
- lamotrigine (Lamictal)
- levetiracetam (Keppra)
- oxcarbazepine (Trileptal, Oxtellar XR)
- phenytoin (Dilantin, Phenytek)
Questions about taking topiramate oral tablet
Below, we review some common questions about taking topiramate oral tablets.
- What if I miss a dose of topiramate oral tablets? It depends on how much time remains until your next scheduled dose. If your next dose is more than 6 hours away, take your missed dose as soon as possible. But if there are 6 hours or less until your next dose is due, just skip the missed dose. Don’t take a double dose to make up for the missed dose.
- Will I need to use topiramate oral tablets long term? Topiramate oral tablets are meant to be a long-term treatment. If you and your doctor decide that topiramate is safe and effective for your condition, you’ll most likely take it long term.
- Can topiramate oral tablets be chewed, crushed, or split? Due to their bitter taste, topiramate oral tablets should not be broken, chewed, or crushed. Instead, these tablets should be swallowed whole.
- Should I take topiramate oral tablets with food? You can take topiramate oral tablets with or without food. It’s best to avoid a ketogenic diet (a diet high in fat and low in carbs) while you’re taking topiramate. This is because following a ketogenic diet could increase your risk for side effects from topiramate. These side effects include kidney stones and metabolic acidosis (high acid level in your blood).
- How long do topiramate oral tablets take to work? When you start taking topiramate oral tablets, your doctor will prescribe a low dose. Then, your dose will be slowly increased over the first few weeks of treatment. During this time, the drug’s levels are slowly building up in your system. So, it may take a few weeks or a month for you to notice an improvement in your condition.
Questions for your doctor
You may have questions about topiramate oral tablets and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will topiramate oral tablets affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.
Before starting treatment with topiramate oral tablets, be sure to talk with your doctor about a few important considerations. These include your current and past health conditions, current medications, and any health goals that you have.
Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.
Before taking topiramate oral tablets, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with topiramate oral tablets.
Interactions with drugs
Topiramate oral tablet can interact with several types of drugs. These drugs include:
- contraceptive drugs that contain estrogen,* such as:
- certain birth control pills
- certain other seizure medications, such as:
- carbamazepine (Tegretol)
- phenytoin (Dilantin)
- central nervous system depressants (drugs or substances that slow down the activity of your brain and spinal cord), such as:
- opioid pain relievers, such as oxycodone
- sedatives, such as zolpidem (Ambien)
- certain medications used to treat mental health conditions, such as lithium
This list does not contain all types of drugs that may interact with topiramate oral tablets. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of topiramate oral tablets.
* Topiramate can decrease the effectiveness of birth control drugs that contain estrogen. (Ethinyl estradiol is a form of estrogen that’s often an active ingredient in birth control pills, patches, or rings.) If you become pregnant while you’re taking topiramate, you’ll have an increased risk for fetal development problems or low birth weight. If you’re able to become pregnant, talk with your doctor about effective birth control options before taking topiramate.
Topiramate oral tablets can interact with supplements. The drug can also be affected by your diet.
Interactions with supplements
There aren’t any specific interactions known to occur between herbal supplements and topiramate oral tablets.
But some herbal supplements may have central nervous system depressant effects. (They can slow down the activity of your brain or nerves.) Topiramate works by reducing the activity of your brain. So, using topiramate with other treatments that do this may reduce your brain activity too much. And this can lead to adverse effects.
It’s important to ask your doctor or pharmacist before taking any herbs or dietary supplements while you’re taking topiramate.
Interactions with foods
There aren’t any specific foods that are known to interact with topiramate oral tablets.
But while you’re taking topiramate it’s best to avoid the ketogenic diet (a high-fat, low-carb diet). The ketogenic diet could increase your risk for kidney stones with topiramate. It also increases your risk for metabolic acidosis (high acid level in your blood).
It’s also important to stay well-hydrated while you’re taking topiramate. Drinking plenty of fluids with this medication can reduce your risk for kidney stones.
Topiramate oral tablets may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take topiramate oral tablets. Factors to consider include those in the list below.
- Kidney disease or kidney stones. If you’ve had kidney stones or other kidney problems, you could have a higher risk for kidney stones with topiramate. You could also have an increased risk for metabolic acidosis (high acid level in your blood). If you’ve had kidney stones or other kidney problems, your doctor may recommend a different treatment option for your condition. Or they may check certain blood tests during your treatment to monitor your acid level and kidney health.
- Liver problems. If you’ve had liver problems, topiramate may increase your risk for having a high level of ammonia in your blood. Your doctor may use certain blood tests during your treatment to monitor your liver health and ammonia level.
- Glaucoma or other eye problems. Topiramate can possibly cause eye and vision problems, including glaucoma (increased pressure in your eye). If you already have glaucoma or other eye problems, taking this drug could worsen your condition. Your doctor may recommend having your eyes monitored more carefully during treatment with topiramate.
- Breathing problems. If you have a history of any breathing or lung problems, these conditions may increase your risk for metabolic acidosis. Because topiramate can also cause metabolic acidosis, you may have an increased risk for this side effect.
- Suicidal thoughts or behaviors. Taking topiramate may raise your risk for suicidal thoughts or behaviors. If you’ve had suicidal thoughts or behaviors, depression, or mood problems, your doctor may monitor you more closely while you’re taking topiramate.
- Weak or soft bones. If you’ve had bone problems, such as osteoporosis, topiramate treatment could possibly make your condition worse. This can further weaken your bones and increase your risk of broken bones. Your doctor may recommend certain tests to monitor your acid levels and bone health if they prescribe topiramate for you.
- Ketogenic diet. Following a ketogenic diet (a high-fat, low-carb diet) isn’t recommended while you’re taking topiramate. This diet could increase your risk for kidney stones with topiramate. It could also increase your risk for metabolic acidosis. If you follow a ketogenic diet, talk with your doctor about other treatment or diet options.
- Allergic reaction. If you’ve had an allergic reaction to topiramate oral tablets or any of their ingredients, you shouldn’t take topiramate oral tablets. Ask your doctor whether any other medications may be better options for you.
Use with alcohol
Drinking alcohol isn’t recommended while you’re taking topiramate oral tablets. Alcohol can increase your risk for certain side effects of topiramate, such as:
- problems with speaking, confusion, or memory
- slowed reactions
Additionally, an interaction between topiramate and alcohol could increase your risk for serious side effects. These include:
If you have questions about alcohol use with topiramate, talk with your doctor.
Pregnancy and breastfeeding
It’s recommended that you don’t use topiramate oral tablets during pregnancy.
This is because taking topiramate during pregnancy can be harmful. Studies show that babies born to people who took topiramate during pregnancy had an increased risk for:
- a development problem known as cleft lip or cleft palate
- low birth weight, which can cause breathing problems and other health concerns
If you’re pregnant or planning to become pregnant, talk with your doctor about the safety of topiramate oral tablets.
If you take topiramate while breastfeeding, this drug will pass into your breast milk. This means that the drug can affect a child who’s breastfed.
There’ve been reports of diarrhea and excessive sleepiness in children who were breastfed whose mothers took topiramate.
If you’re breastfeeding or planning to breastfeed, discuss the risks and benefits with your doctor.
Don’t take more topiramate oral tablets than your doctor prescribes. Taking more than this can lead to serious side effects, including, in some cases, death.
Symptoms of overdose
Symptoms caused by an overdose of topiramate oral tablets may include:
- extreme drowsiness
- trouble speaking
- blurry or double vision
- feeling dazed or confused
- clumsiness or problems with coordination
- low blood pressure
- belly pain
- feeling agitated or restless
- metabolic acidosis (high level of acid in your blood), which can cause abnormal heart beat, shortness of breath, or loss of appetite
What to do in case you take too much topiramate oral tablet
Call your doctor if you think you’ve taken too many topiramate oral tablets. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for topiramate oral tablets in your area, visit GoodRx.com.
Financial assistance to help you pay for topiramate oral tablets may be available. Medicine Assistance Tool and NeedyMeds are two websites that provide resources to help reduce the cost of topiramate oral tablets.
These websites also offer tools to help you find low-cost healthcare and certain educational resources. To learn more, visit their websites.
If you get migraine headaches or certain types of seizures, your doctor may recommend topiramate oral tablets. For details about the approved uses of topiramate, see the “What is topiramate oral tablet used for?” section above.
You may want to ask your doctor if topiramate could be helpful for your condition. Learn more about medication treatment options for seizure disorders here. And read more about medication treatment options for migraine here.
If you and your doctor are considering topiramate oral tablets for your condition, here are some questions you may want to ask:
- When I start taking topiramate for migraine prevention, can I still take my other migraine medications if I get a migraine headache?
- Am I at higher risk for side effects from topiramate oral tablets because of my medical history?
- Is it okay to take over-the-counter medications with topiramate oral tablets?
- Would a different form of topiramate be a better option for me, such as an extended-release form?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.