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What Topamax is and what it is used for
Topamax belongs to a group of medicines called “antiepileptic medicines.” It is used: alone to treat seizures in adults and children over age 6 with other medicines to treat seizures in adults and children over age 2 to prevent migraine headaches in adults
Before you takeTopamax
Do not take Topamax if you are allergic (hypersensitive) to topiramate or any of the other ingredients of Topamax (listed in section 6) for migraine prevention if you are pregnant, or you are able to become pregnant but you are not using effective contraception (see section „pregnancy and breast-feeding‟ for further information) If you are not sure if the above applies to you, talk to your doctor or pharmacist before using Topamax.
Take special care with Topamax
Check with your doctor or pharmacist before taking Topamax if you: have kidney problems, especially kidney stones, or are getting kidney dialysis have a history of blood and body fluid abnormality (metabolic acidosis) have liver problems have eye problems, especially glaucoma have a growth problem are on a high fat diet (ketogenic diet) If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Topamax. It is important that you do not stop taking your medicine without first consulting your doctor. You should also talk to your doctor before taking any medicine containing topiramate that is given to you as an alternative to Topamax. You may lose weight if you use Topamax so your weight should be checked regularly when using this medicine. If you are losing too much weight or a child using this medicine is not gaining enough weight, you should consult your doctor. A small number of people being treated with antiepileptic medicines such as Topamax have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, vitamins and herbal medicines. Topamax and certain other medicines can affect each other. Sometimes the dose of some of your other medicines or Topamax will have to be adjusted. Especially, tell your doctor or pharmacist if you are taking: other medicines that impair or decrease your thinking, concentration, or muscle coordination (e.g., central nervous system depressant medicines such as muscle relaxants and sedatives) birth control pills. Topamax may make your birth control pills less effective Tell your doctor if your menstrual bleeding changes while you are taking birth control pills and Topamax. Keep a list of all the medicines you take. Show this list to your doctor and pharmacist before you start a new medicine. Other medicines you should discuss with your doctor or pharmacist include other antiepileptic medicines, risperidone, lithium, hydrochlorothiazide, metformin, pioglitazone, glyburide, amitriptyline, propranolol, diltiazem, venlafaxine, flunarazine. If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Topamax.
Taking Topamax with food and drink
You can take Topamax with or without food. Drink plenty of fluids during the day to prevent kidney stones while taking Topamax. You should avoid drinking alcohol when taking Topamax.
Pregnancy and breast-feeding
Talk to your doctor before using Topamax if you are pregnant, trying to become pregnant or breast-feeding. Your doctor will decide if you can take Topamax. As with other antiepilepsy medicines, there is a risk of harm to the unborn child if Topamax is used during pregnancy. Make sure you are very clear about the risks and the benefits of using Topamax for epilepsy during pregnancy. You should not take Topamax for migraine prevention if you are pregnant or you are able to become pregnant and you are not using effective contraception. Mothers who breast-feed while taking Topamax must tell the doctor as soon as possible if the baby experiences anything unusual. Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
Dizziness, tiredness and vision problems may occur during treatment with Topamax. Do not drive or use any tools or machines without talking to your doctor first. Important information about some of the ingredients of Topamax Topamax tablets contain lactose. If your doctor has told you that you are intolerant of some sugars, discuss it with them before taking this medicine
How to take Topamax
Always take Topamax exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Take Topamax exactly as prescribed. Your doctor will usually start you on a low dose of Topamax and slowly increase your dose until the best dose is found for you Topamax tablets are to be swallowed whole. Avoid chewing the tablets as they may leave a bitter taste. Topamax can be taken before, during or after a meal. Drink plenty of fluids during the day to prevent kidney stones while taking Topamax If you take more Topamax than you should See a doctor right away. Take the medicine pack with you You may feel sleepy or tired, or have abnormal body movements, problems standing and walking, feel dizzy due to low blood pressure, or have abnormal heartbeats or fits.
can happen if you are taking other medicines together with Topamax. If you forget to take Topamax If you forget to take a dose, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue as usual. If you miss two or more doses, contact your doctor Do not take a double dose (two doses at the same time) to make up for a forgotten dose If you stop taking Topamax Do not stop taking this medicine unless told to do so by your doctor. Your symptoms may return. If your doctor decides to stop this medication, your dose may be decreased gradually over a few days. If you have any further questions on the use of this product, ask your doctor or pharmacist.
Possible side effects
Like all medicines, Topamax can cause side effects, although not everybody gets them. Very common side effects include: Weight loss Tingling in the arms and legs Drowsiness or sleepiness Dizziness Diarrhoea Nausea Stuffy, runny nose and sore throat Tiredness Depression Common side effects include: Changes in mood or behaviour, including anger, nervousness, sadness Weight gain Decrease or loss of appetite Reduced number of red blood cells Changes in thinking and alertness, including confusion, problems with concentration, memory or slowness in thinking Slurred speech Clumsiness or problems with walking Involuntary shaking in the arms, hands or legs Reduced sense of touch or sensation Involuntary movement of the eyes Distorted sense of taste Visual disturbance, blurred vision, double vision Ringing sound in the ears Ear pain Shortness of breath Nose bleeds Vomiting Constipation Stomach pain Indigestion Dry mouth Tingling or numbness of the mouth Kidney stones Frequent urination Painful urination Hair loss Skin rash and/or itchy skin Joint pain Muscle spasms, muscle twitching or muscle weakness Chest pain Fever Loss of strength General feeling of feeling unwell Allergic reaction Uncommon side effects include: Crystals in the urine Abnormal blood counts, including reduced white blood cell count or platelet count, or increased eosinophils Irregular heartbeat or slowness of the heartbeat Swollen glands in the neck armpit or groin Increase in seizures Problems with verbal communication Drooling Restlessness or increased mental and physical activity Loss of consciousness Fainting Slow or diminished movements Disturbed or poor quality sleep Impaired or distorted sense of smell Problems with handwriting Feeling of movement under the skin Eye problems including dry eyes, light sensitivity, involuntary twitching, tearing and decreased vision Decreased or loss of hearing Hoarseness of the voice Inflammation of the pancreas Gas Heartburn Loss of sensitivity to touch in the mouth Bleeding gums Fullness or bloating Painful or burning sensations in the mouth Breath odour Leakage of urine and/or stools Urgent desire to urinate Pain in the kidney area and/or bladder caused by kidney stones Decrease or loss of sweating Skin discolouration Localized swelling in the skin Swelling of the face Swelling of the joints Musculoskeletal stiffness Increased acid levels in the blood Low potassium levels in the blood Increased appetite Increased thirst and drinking abnormally large amounts of fluid Low blood pressure or decrease in blood pressure that occurs when you stand up Hot flushing Flu like illness Cold extremities (e.g., hands and face) Problems with learning Disturbances in sexual function (erectile dysfunction, loss of libido) Hallucinations Decreased verbal communication Rare side effects include: Excessive skin sensitivity Impaired sense of smell Glaucoma which is a blockage of fluid in the eye causing increased pressure in the eye, pain and decreased vision Renal tubular acidosis Severe skin reaction, including Stevens-Johnson syndrome, a life threatening skin condition in which the upper layer of the skin separates from the lower, and erythma multiforme, a condition of raised red spots that can blister Odour Swelling in the tissues around the eye Raynaud‟s syndrome. A disorder affecting the blood vessels, in the fingers, toes, ears and causing pain and cold sensitivity Tissue calcification (calcinosis) Side effects of unknown frequency Maculopathy is a disease of the macula, the small spot in the retina where vision is keenest. You should call your doctor if you notice a change or decrease in your vision Swelling of the conjunctiva of the eye Toxic epidermal necrolysis which is a more severe form of Stevens-Johnson syndrome (see uncommon side effects) If you get side effects and they become serious or if you notice any other side effects not listed in this leaflet, please tell your doctor or pharmacist.
How to store Topamax
Keep out of the reach and sight of children Keep the container tightly closed in order to protect from moisture Do not store above 25°C. Store in the original package Do not use Topamax tablets after the expiry date which is stated on the blister/bottle/carton. The expiry date refers to the last day of that month Medicines should not be disposed of via wastewater or household waste. These measures will help protect the environment. Return any leftover Topamax tablets to your pharmacist
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