Before Using

Drug information provided by: Merative, Micromedex®

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of topiramate capsules, oral solution, or tablets, or Qudexy® extended-release capsules to treat seizures in children younger than 2 years of age (when used alone or together with other medicines). However, children are more likely to have unwanted effects (eg, rickets, slow growth, and increased risk of kidney stones) to this medicine. Safety and efficacy have not been established.

Appropriate studies have not been performed on the relationship of age to the effects of Trokendi XR® extended-release capsules for the treatment of seizures in children younger than 6 years of age.

Appropriate studies have not been performed on the relationship of age to the effects of topiramate capsules, extended-release capsules, tablets, or oral solution for the prevention of migraine headaches in children younger than 12 years of age. Safety and efficacy have not been established.

Geriatric

Although appropriate studies on the relationship of age to the effects of topiramate have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of topiramate in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving topiramate.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acepromazine
  • Acetazolamide
  • Alfentanil
  • Alprazolam
  • Amitriptyline
  • Amobarbital
  • Anileridine
  • Apixaban
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Asenapine
  • Baclofen
  • Benperidol
  • Benzhydrocodone
  • Brinzolamide
  • Bromazepam
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Calcifediol
  • Calcium Oxybate
  • Cannabidiol
  • Cannabis
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Cetirizine
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Citalopram
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Codeine
  • Cyclobenzaprine
  • Daridorexant
  • Desogestrel
  • Dexmedetomidine
  • Diacetylmorphine
  • Diazepam
  • Dichloralphenazone
  • Dichlorphenamide
  • Dienogest
  • Difenoxin
  • Dihydrocodeine
  • Diphenhydramine
  • Diphenoxylate
  • Dorzolamide
  • Doxylamine
  • Droperidol
  • Drospirenone
  • Enflurane
  • Esketamine
  • Estazolam
  • Estetrol
  • Estradiol
  • Eszopiclone
  • Ethchlorvynol
  • Ethinyl Estradiol
  • Ethopropazine
  • Ethylmorphine
  • Ethynodiol
  • Etonogestrel
  • Fentanyl
  • Flibanserin
  • Flunitrazepam
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fosphenytoin
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Gestodene
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrochlorothiazide
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Isoflurane
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Lacosamide
  • Lemborexant
  • Levocetirizine
  • Levonorgestrel
  • Levorphanol
  • Lithium
  • Lofexidine
  • Lorazepam
  • Loxapine
  • Magnesium Oxybate
  • Meclizine
  • Medroxyprogesterone
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Mestranol
  • Metaxalone
  • Metformin
  • Methadone
  • Methazolamide
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Metoclopramide
  • Midazolam
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nicomorphine
  • Nifedipine
  • Nitrazepam
  • Nitrous Oxide
  • Nomegestrol
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Olanzapine
  • Opium
  • Opium Alkaloids
  • Orlistat
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenytoin
  • Pimozide
  • Pioglitazone
  • Piperacetazine
  • Piperaquine
  • Pipotiazine
  • Piritramide
  • Potassium Oxybate
  • Prazepam
  • Pregabalin
  • Primidone
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Remifentanil
  • Remimazolam
  • Remoxipride
  • Rivaroxaban
  • Ropeginterferon Alfa-2b-njft
  • Scopolamine
  • Secobarbital
  • Segesterone
  • Sertindole
  • Sodium Oxybate
  • Sufentanil
  • Sulpiride
  • Suvorexant
  • Tapentadol
  • Temazepam
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Tilidine
  • Tizanidine
  • Tolonium Chloride
  • Tramadol
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Ulipristal
  • Valproic Acid
  • Venlafaxine
  • Zaleplon
  • Zolpidem
  • Zopiclone
  • Zotepine
  • Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ginkgo
  • Phenobarbital
  • Posaconazole

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is not recommended. Your doctor may decide not to treat you with this medication, change some of the other medicines you take, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone problems (eg, osteoporosis, osteomalacia, osteopenia) or
  • Depression, history of or
  • Eye or vision problems (eg, glaucoma) or
  • Mood disorder, history of or
  • Metabolic acidosis (too much acid in the blood), or history of—Use with caution. May make these conditions worse.
  • Diarrhea or
  • Lung or breathing problems or
  • Patients on ketogenic diet or
  • Status epilepticus (prolonged seizure)—May increase risk for metabolic acidosis.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Patients with metabolic acidosis who are also taking metformin—Should not be used in patients with this condition.
  • Patients undergoing hemodialysis—Use with caution. The effects of Topamax®, Trokendi XR®, or Eprontia™ may be lessened because of its faster removal from the body.