Topiramate Tips from Pharmacists

• Your doctor will start you on a lower dose of topiramate and gradually increase the dose every 1-2 weeks. Follow the dosing instructions carefully.

• Do not switch between the different formulations of topiramate without checking with your healthcare provider. Topiramate formulations have different age cut-offs and directions for use.

• Do not chew topiramate tablets (this can leave a bitter taste in your mouth). Also, do not cut or break the tablets, as this can make them less effective.

• The extended-release capsules and sprinkle capsules can be opened, and their contents sprinkled on some soft food like applesauce. Do not chew or crush the capsules.

• If you are taking the oral solution (brand name Eprontia), use a dose-measuring device and not a kitchen spoon to measure the dose. Discard any unused topiramate solution 2 months after opening the bottle.

• Do not stop taking topiramate suddenly. This can result in an increased seizure frequency. Your doctor will tell you how to lower the dose slowly.

• Avoid drinking alcohol while on topiramate as it can make side effects like dizziness and drowsiness worse. Do not drink alcohol within 6 hours of taking extended-release topiramate capsules (brand name Trokendi XR).

• Drink plenty of water and stay well hydrated while on topiramate.

• Topiramate can cause drowsiness, dizziness, and decreased mental alertness. Do not drive or perform any hazardous activities until you know how this medicine affects you.

• Keep all your medical and lab appointments while on this medicine. Your doctor may want to order certain blood tests to check acid levels in your blood. 

• Avoid unnecessary heat exposure while on topiramate. Do not exercise outdoors in hot weather. Drink enough water. Get immediate medical attention if you become overheated or have decreased sweating.