February 26, 2015

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What side effects are possible with Topamax?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • altered taste
  • constipation
  • decreased appetite
  • diarrhea
  • drowsiness
  • headache
  • heartburn
  • increased sweating
  • nausea
  • tremor

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • aggressive behaviour
  • agitation
  • back pain
  • burning or tingling sensations
  • chest pain
  • confusion
  • decreased appetite
  • depressed mood
  • difficulty breathing
  • difficulty concentrating
  • difficulty sleeping
  • dizziness
  • eye pain
  • flushing
  • memory problems
  • nervousness
  • physical or mental slowing
  • red eyes
  • skin rash
  • speech disorders (e.g. hesitancy or word-finding difficulty)
  • swelling
  • unusual tiredness
  • upper respiratory tract infection (e.g. colds, bronchitis)
  • vision changes
  • weight loss

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Topamax?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Birth control: Topiramate has been shown to affect birth control pills that contain low doses of estrogen. If you are a woman taking birth control pills you should receive a preparation containing not less than 30 µg of estrogen and report any changes in bleeding patterns to your doctor.

Drowsiness/reduced alertness: Topiramate can cause difficulty with concentration, speech or language problems, and drowsiness or fatigue. If you are taking this medication you should not drive or operate machinery until you have had a chance to see if it affects your mental or physical performance.

Heat regulation: For some people, especially children, topiramate may cause decreased sweating and increased body temperature. Let your doctor know if you or a child taking this medication experiences these symptoms. Proper hydration during exposure to warm temperatures, as well as before and during exercise, is recommended.

Kidney stones: Approximately 1.5% of people taking topiramate develop kidney stones. Men seem to be at greater risk for this. Be sure to drink plenty of fluids while taking this medication in order to reduce the risk of kidney stone formation.

Laboratory tests: Topiramate may decrease sodium bicarbonate levels and lead to metabolic acidosis. Sodium bicarbonate levels should be monitored by your doctor.

Liver function: Topiramate should be used with caution by people with decreased liver function.

Stopping treatment: Topiramate should be stopped gradually to decrease the risk of seizures. Do not stop taking this medication without talking to your doctor.

Vision changes: If you are taking topiramate you should immediately report blurred vision or painful and red eyes to a doctor. If left untreated, these symptoms can lead to permanent vision loss.

Pregnancy: There are no studies on the use of topiramate by pregnant women. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Limited information shows that topiramate is found in breast milk. If you are a breast-feeding mother and taking topiramate, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: Topiramate can be used in children aged 2 and older. The safety and effectiveness of using this medication have not been established for children under the age of 2.

What other drugs could interact with Topamax?

There may be an interaction between topiramate and any of the following:

  • acetazolamide
  • amitriptyline
  • carbamazepine
  • digoxin
  • CNS depressants (medications that slow down the central nervous system, such as alcohol, sedatives, or morphine)
  • hydrochlorothiazide
  • metformin
  • oral contraceptives (birth control pills)
  • phenytoin
  • pioglitazone
  • risperidone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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