Topamax (topiramate) is an anti-epilepsy drug that is used to prevent seizures. It can be used in adults and children who are two years old or older.

The drug also treats Lennox-Gastaut syndrome in children, can be used as an anti-migraine medicine for adults and teenagers who are 12+ and as a medicine for addictions to alcohol, methamphentamine and cocaine, obesity and post-traumatic stress disorder. The main principle of its work is that it widens the blood vessels.


It is strongly recommended to use the drug exactly as prescribed by your doctor: the exact dosage, time and length of the course.

Don’t take it longer than prescribed, or in smaller or larger dosages. Don’t stop the treatment as it may cause more seizures. Take a missed dose if not more than 6 hours have passed since the scheduled time. If it’s been 6 or more hours, skip it to avoid overdose as it may make you feel depressed, agitated, drowsy, slow-thinking or cause seizures. Doses for children from 2 to 10 years old depend on their weight.

The smallest dose is 25 mg per day, then it can be higher – 50 mg per day (25 mg twice a day).

Topamax is produced in tablets and capsules. Tablets should be swallowed with water and shouldn’t be crushed or chewed.

Capsules may be swallowed with or without water or sprinkled into a spoon and taken with some food. Both tablets and capsules can be taken in between the meals or during them. Topamax is to be stored in a dark, dry place in room temperature (20-25 C)

While taking the medication it is important to:

  • Drink a lot of water;
  • Avoid drinkingalcohol;
  • Avoid heat;
  • Try to eat less fat food;
  • Avoid taking part in mental activities that require concentration and coordination such as driving;
  • Avoid physical activities that may cause sudden seizures such as hiking, climbing, swimming, etc.

It is important to make blood tests while taking Topamax, as it increases the level of acid in the blood.


Don’t take Topamax if you’re allergic to topiramate, its active ingredient.

Consult your doctor before taking Topamax if you’re pregnant or breastfeeding. Inform a healthcare provider in case you get pregnant while using this medication. Ask a doctor about taking Topamax if you have diabetes, kidney or liver disease, diarrhea, problems with your eyes, problem breathing, osteoporosis or depression and if you take lithium.

Side Effects It May Cause

If you have allergic reactions: your throat, face, tongue or lips are swelling, you have hives or difficulty breathing – call the emergency right away.

Contact a doctor immediately if you feel depressed, aggressive, hyperactive and it’s getting worse, if you have problems with your eyes, memory, concentration or speech, if you vomit or have fever and dry skin.

It is common to experience dizziness, tingling in arms and legs, headache, tiredness, loss of appetite, stomach pain, weight loss, changes in sense of taste.

Can It Be Used with Other Medicines?

Topamax used with other carbonic anhydrase (acetazolamide, zonisamide, dichlorphenamide, etc.) increases the chances of having kidney stones.

If taken with enzyme inducers, the dose of the drug might need to be increased. If you take Topamax with drugs that make you want to sleep, this effect will be stronger. Besides, don’t take the medication with metformin or lithium. It is strongly recommended to consult a doctor if you want to use Topamax at the same time with CNS depressants, because it may make you feel very depressed and even have suicidal thoughts.

Moreover, it can worsen the effectiveness of oral contraceptives.