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Topiramate
Topiramate is a medication used to control seizures in epilepsy and prevent migraines. It may also be used for weight control in conjunction with other drugs. Some common side effects include fatigue, nervousness, coordination problems, and speech difficulties, but its pros usually overshadow these challenges.
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Frequently Asked Questions
Can Topiramate be used for weight loss?
Yes, it can be used for weight loss but typically in combination with other medications and under medical supervision.
Does Topiramate affect birth control?
Topiramate may make birth control pills less effective, so it's important to discuss this with your doctor.
What should I do if I miss a dose of Topiramate?
Take it as soon as possible. However, if it's nearly time for the next dose, skip the missed one. Never take double doses.
What happens if I stop taking Topiramate suddenly?
Abruptly stopping topiramate can trigger withdrawal symptoms and increase seizure frequency. Always consult your doctor when deciding to stop the medication.
Can Topiramate affect my mood?
Yes, it can cause mood changes and even depression in some people. If you start feeling unusually sad, anxious or have suicidal thoughts, inform your healthcare provider immediately.
Comprehensive Drug Guide
How Does Topiramate Work?
Topiramate is an anticonvulsant that works by decreasing hyperactivity in the brain. It dampens the overactive electrical nerve activity that is a part of seizure and migraine conditions.
What is Topiramate Used For?
FDA indications: Topiramate is primarily used to control seizures in certain types of epilepsy and to prevent migraine headaches.
Off-label uses: It's also used for weight loss in combination with certain other medications, and for the treatment of bipolar disorder as a mood stabilizer.
Common Dosages
Immediate-release tablets: 25mg, 50mg, 100mg, 200mg
Extended-release capsules: 25mg, 50mg, 100mg, 150mg, 200mg
Typical Dosing
FDA Approved Indications
- For FDA-approved indications:
- Epilepsy: Initial dose of 25 to 50mg daily, increased gradually to a usual dose of 200 to 400mg per day.
- Migraine prevention: The usual dose is 50 to 100mg per day.
Off-Label Uses
- For off-label uses:
- Bipolar disorder: Dosage ranges between 100 and 200mg per day.
- Weight loss (in combination with phentermine): 23mg once daily for 14 days.
Who Shouldn't Take Topiramate?
- Have kidney problems or a history of kidney stones.
- Have liver problems.
- Have lung or breathing problems.
- Have eye conditions, particularly glaucoma.
- Are prone to mood disorders, like depression or suicidal thoughts.
- Have poor bone health or osteoporosis.
- Are pregnant, planning to become pregnant, or breastfeeding (it could harm the baby).
Advice From The Pharmacist
- Stay hydrated. Topiramate could increase kidney stone risk.
- Avoid activities until you know how topiramate affects you as it can cause dizziness or impair your coordination.
- If you're taking the extended-release capsules, swallow them whole. Do not crush or chew them.
- Do not stop taking topiramate suddenly as this could lead to withdrawal seizures.
- Monitor for mood changes. Topiramate can cause depression and suicidal thoughts.
- Regular eye examinations are recommended due to the risk of glaucoma.
Interactions with Topiramate
Common Drug Interactions
- Valproate
- Metformin
- Oral contraceptives
- Carbonic anhydrase inhibitors (e.g., Acetazolamide)
- CNS Depressants (like Alcohol, Opioids)
Alternatives to Topiramate
- Gabapentin
- Lamotrigine
- Levetiracetam
- Phenobarbital
- Phenytoin
- Valproic Acid
