Topiramate
- How it worksAlthough topiramate is FDA-approved for treating seizures and preventing migraines, it is also commonly used by leading specialist obesity clinicians and weight clinics off-label to help aid with weight loss by reducing appetite and cravings.
- Form and dosingTopiramate typically comes in a tablet form and extended release capsules (25 mg, 50 mg, 100 mg and 200 mg) and sprinkle capsules (15 mg and 25 mg) and extended release sprinkle capsules (25 mg, 50 mg, 100 mg, 150 mg, 200 mg) and liquid form (25 mg/ml). Dosing instructions vary according to weight, tolerability and other factors and should be discussed with your healthcare provider.
- Common side effects
- anorexia
- weight loss
- dizziness
- fatigue or drowsiness
- difficulty with concentration and
- psychomotor slowing
- speech difficulty
- nervousness
- tingling or prickling sensations
- abnormal vision
- fever
WARNINGBefore using topiramate, tell your healthcare provider about your medical history, especially if you have:
- narrow angle glaucoma and
- nearsightedness
- kidney problems, such as kidney stones
- liver problems
- depression or thoughts of suicide
- lung or breathing problems
- metabolic acidosis
- high blood ammonia levels
- long-term diarrhea
- low body temperature
- a diet high in fat and low in carbohydrates, aka a ketogenic diet
- brittle bones
Topiramate may cause some people to sweat less. It is recommended to avoid alcohol and stay well hydrated while taking this medication.This drug may make you dizzy or drowsy or impair your judgment. Please do not drive, operate heavy machinery, or perform any hazardous task until the effects of topiramate are known to you. For anyone taking diabetes medications, please have a discussion with your prescribing clinician prior to taking topiramate as your diabetes medications may need to be adjusted as you lose weight.
Topiramate may also cause birth defects (particularly there is a risk of cleft lip and/or palate and low birth weight). Topiramate may cause breakthrough bleeding. DO NOT take topiramate if you are planning to become pregnant or if pregnant or breastfeeding.
Side effects informationMany people experience no side effects while taking topiramate. Some of the most common side effects (but not extremely frequent) are:
- anorexia
- weight loss
- dizziness
- fatigue or drowsiness
- difficulty with concentration and psychomotor slowing
- speech difficulty
- nervousness
- tingling or prickling sensations
- abnormal vision
- fever
Additional side effects include:
- difficulty with memory
- changes in taste
- diarrhea
- numbness
- nausea
- abdominal pain
- upper respiratory tract infection
- hair loss
- changes in mood/suicidal thoughts
These symptoms may subside after the body adjusts to the medication.
Drug interactionsAs with other medications, topiramate can interact with alcohol, marijuana and certain medications, including antiepileptic drugs, CNS depressants, oral contraceptives, lithium, other carbonic anhydrase inhibitors, hydrochlorothiazide, pioglitazone and amitriptyline. Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information.
To report suspected adverse reactions to topiramate contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
In case of emergencies, please call 911 or go to the nearest emergency room.