Topiramate

About

Topiramate is an anti-seizure medication. It can be useful in multiple types of seizures. Topiramate has been found to be effective in focal seizures, generalised seizures, and Lennox Gastaut Syndrome.

It must be prescribed by a doctor. You should never give your child anyone else's medications.

Side effects

All medications have side effects. Not everyone will experience side effects.

Below are some of the possible side effects your child may experience.

  • Marked loss of appetite/loss of weight (may be dose dependant)
  • Kidney stones - all patients must drink plenty of fluids and report any back pain or pain on urination to their doctor
  • Inability to tolerate heat due to reduced sweating. Take precautions to prevent over heating especially in the  under-2-year-olds
  • Sedation, usually with higher doses
  • Irritability, crankiness, depression,  or mood changes can occur
  • Changes in learning ability
  • Decreased attention
  • Problems with word finding and speech
  • In young babies, a higher level of acid in the blood may occur. Your doctor will monitor with blood tests and treat as needed
  • Fatigue
  • Blurred vision

Rare Side Effects

  • Visual field deficit has been described occasionally
  • Numbness and hand tingling
  • Any eye pain needs to be evaluated urgently as glaucoma can rarely occur

Interactions

Your Doctor will check and make sure that other drugs your child is taking are compatible with Topiramate. This is also important if you are giving your child herbal or complementary medicines. The doctor can check to make sure they are compatible.

There are interactions between Topamax and other anticonvulsants (for example Valproate).

Need-to-know

Monitoring and Levels

  • Occasional blood tests may be required, particularly if your child seems unwell or has kidney pain.
  • A urine test maybe required to check for blood or calcium.
  • An ultrasound is done if a kidney stone is suspected.

Pregnancy and contraception

  • Topiramate may influence the oral contraceptive pill, altering how it works.
  • Topiramate can rarely cause malformations of a baby in the uterus.
  • If a pregnancy is planned, a discussion with your neurologist is recommended.
  • For further information, refer to the Contraception and Pregnancy section.

 

Disclaimer

The information provided in this handout is limited and does not replace the need for a medical consultation. It is very important you speak to your doctor about all aspects of your medication including side effects when medication is first prescribed. Report any concerns to your doctor promptly.