Generic name: Topiramate.

Topamax is an anticonvulsant. It works by rebalancing certain chemicals in the brain.

Quick Facts About Topamax


Used to treat partial seizure in adults with epilepsy in conjunction with other anticonvulsants such as carbamazepine (Tegretol) and phenytoin (Dilantin) Effects set in after 2 months of treatment.

Topamax Dosage

Take exactly as prescribed. Do not break tablets.

  • Usual adult dose: initially — 50 milligrams once per day. Doctor will increase dose to 200 milligrams twice per day. For people with kidney failure, initially — 25 milligrams once per day.
  • Usual child dose: not generally prescribed for children.
  • Missed dose: take as soon as possible, unless almost time for next dose. In that case, do not take missed dose; go back to regular schedule. Do not double doses.

Topamax Side Effects

Overdose symptoms:

nervous system depression. If you suspect an overdose, immediately seek medical attention.

More common side effects: depression, difficulty concentrating, difficulty speaking (especially finding words), dizziness, nausea, “pins and needles” in hands and feet, poor muscle coordination, respiratory infection, slow reflexes or thought processes, tiredness, tremors, vision problems, weakness.

Less common Topamax side effects: abdominal pain, agitation or aggressive reactions, apathy, appetite loss, back or chest pain, body odor, breathing difficulties, constipation, depersonalization, dry mouth, eye pain, hearing loss, hot flushes, itching, leg pain, menstrual disorders, mood changes, muscle ache, rash, reduced touch sensation, sinus inflammation, sore throat, swelling, upset stomach, weight loss. May cause rare side effects in any body system.


Inform your doctor before combining Topamax with:

carbonic anhydrase inhibitors such as acetazolamide (Dazamide or Diamox), dichlorphenadine (Daranide), and methazolamide (MZM or Neptazane); oral contraceptives; other anticonvulsants such as carbamazepine (Tegretol), phenytoin (Dilantin), and valproic acid (Depakote).

Do not combine alcohol with this medication; may intensify the effects of alcohol.

Special Cautions

Pregnancy: effects of Topamax not known. If pregnant or planning to become pregnant, inform your doctor immediately. Appears in breast milk; could affect a nursing infant.

Seniors with age-related kidney impairment may be prescribed a lower dose.

Not prescribed for children.

  • Do not discontinue use without consulting your doctor; seizures may worsen if you stop treatment abruptly.
  • Inform your doctor before treatment if you have kidney or liver disease. Lower dose may be necessary.
  • Drink several glasses of water every day during treatment to avoid developing kidney stones.
  • May impair your ability to drive a car or operate machinery. Do not take part in any activity that requires mental alertness until adjusted to medication.

Note: provides accurate and independent information prescription pills, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. If you have questions about  dosage, or Topamax side effects, please contact your healthcare provider