Before taking topiramate,
tell your doctor and pharmacist if you are allergic to topiramate, any other medications, or any of the ingredients in topiramate tablets, sprinkle capsules, and extended-release capsules. Ask your pharmacist for a list of the ingredients.
tell your doctor if you have metabolic acidosis (a disturbance in the body's acid-base balance that results in excessive acidity of the blood) and you are taking metformin (Fortamet, Glucophage, Riomet, others). Your doctor will probably tell you not to take metformin if you have metabolic acidosis and you are taking this of medication.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); amitriptyline; antidepressants; antihistamines; digoxin (Lanoxin); hydrochlorothiazide (Microzide, Oretic); lamotrigine (Lamictal); lithium (Lithobid); medications for motion sickness, ulcers, or urinary problems; metformin (Fortamet, Glucophage, Riomet, others); hormonal contraceptives (birth control pills, patches, rings, implants, or injections); other medications for seizures such as carbamazepine (Epitol, Equetro, Tegretol, Teril), phenytoin (Dilantin, Phenytek), valproic acid (Depakene), and zonisamide (Zonegran); and pioglitazone (Actos, in Actoplus Met ER). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you or any family members have or have ever had kidney stones, and if you have ever thought about killing yourself or tried to do so. Also tell your doctor if you have or have ever had metabolic acidosis (a disturbance in the body's acid-base balance that results in excessive acidity of the blood); osteopenia, osteomalacia, or osteoporosis (conditions in which the bones are soft or brittle and may break easily); diabetes; glaucoma (a type of eye disease); any disease that affects your breathing such as asthma or chronic obstructive pulmonary disease (COPD); depression or abnormal moods; a growth problem; or liver or kidney disease. Also tell your doctor if you have diarrhea or if you develop diarrhea during your treatment.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you are pregnant or plan to become pregnant, your doctor may prescribe a different medication instead of topiramate because topiramate may harm the fetus. If you do not plan to become pregnant, you should use birth control to prevent pregnancy during your treatment with topiramate. Talk to your doctor about what type of birth control you should use, because taking topiramate may decrease the effectiveness of some types of birth control. If you become pregnant while you are taking topiramate, call your doctor right away, but do not stop taking topiramate before talking to your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking topiramate.
you should know that topiramate may make you drowsy, dizzy, confused, or unable to concentrate. Do not drive a car or operate machinery until you know how this medication affects you.
if you are taking topiramate to control seizures, you should know that you may continue to have seizures during your treatment. You may need to avoid activities such as swimming, driving, and climbing so that you will not harm yourself or others if you lose consciousness during a seizure.
tell your doctor if you if you drink alcohol. You should not drink alcohol within 6 hours before and 6 hours after you take extended-release capsules (Trokendi XR brand only). Your doctor will probably tell you not to drink alcohol while taking topiramate.
you should know that topiramate can prevent you from sweating and make it harder for your body to cool down when it gets very hot. This happens most often in warm weather and to children who take topiramate. Avoid exposure to heat, drink plenty of fluids and tell your doctor if you have a fever, headache, muscle cramps, or an upset stomach, or if you are not sweating as usual.
you should know that you may be more likely to develop a kidney stone while you are taking topiramate. Drink 6 to 8 glasses of water every day to prevent kidney stones from forming.
you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking topiramate for the treatment of epilepsy, mental illness, or other conditions. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants such as topiramate to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as 1 week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as topiramate, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.