Introduction Topamax

Topiramate affects information transmission through nerves in the brain.

Doctors prescribe it for epilepsy, migraines and bulimia nervosa.

Trade information
Topiramate has been on the market internationally since 1995. It is available by prescription under the brand name Topamax and as the unbranded Topiramate in capsules and tablets.

How should I use Topamax?
Always check the pharmacy label for the correct dosage.

How to.
Swallow the tablets and capsules whole, without chewing, with at least half a glass of water. If you have trouble swallowing whole, you may want to open the capsules. Then swallow the granules from the capsule whole, without chewing them, with some water.

You may take the medicine at any time of the day. It is best to choose fixed times, then you are less likely to forget a dose. If you take it once a day: preferably in the evening. If you take it 2 times a day: morning and evening.

How long.

You will probably need to take this medicine for a long time. After a few weeks to months, your doctor will review with you whether it is effective enough. Your doctor may adjust the dosage in the interim. In any case, never change the dosage yourself.

After a few weeks to months, your doctor will review with you whether it is sufficiently effective. The doctor may adjust the dosage in the meantime. If your number of attacks decreases and you do not suffer too many side effects, you can use it long-term.

Bulimia nervosa
It is not known how long you should take this drug. If you do not notice any effect after 8 weeks, further use is probably not appropriate. Consult with your doctor about this.

Topamax 100mg, 200mg

Active ingredient: Topiramate
Property: treating seizures in certain patients
Format: Compresse orali
Price : $2.04 pill
Conditions of issue: without prescription
Package insert (pdf): download the leaflet here

What side effects should I watch out for?

Apart from the desired effect, this medicine may cause side effects.
The main side effects are the following.


  • Gastrointestinal symptoms, such as nausea and diarrhea, rarely constipation and abdominal pain. This usually disappears on its own after a short time. You can try to prevent nausea by taking the medicine with some food.
  • Reduced appetite, which may cause weight loss. In rare cases, appetite actually increases, which may cause weight gain.
  • Fatigue, dizziness, feeling dizzy. Rarely trembling hands.
  • Sore throat, runny or stuffy nose, rarely coughing. Rarely shortness of breath, especially with exertion.
  • Numbness or tingling sensation in arms or legs.


  • Psychological symptoms, including occasional feelings of depression and rarely feelings of anxiety, irritability or aggression, excited or just sluggish and indifferent behavior, problems with memory and concentration, difficulty talking, confusion, delusions. Very rarely hallucinations, suicidal thoughts or severely diminished consciousness. People with schizophrenia, delusions, hallucinations or severe confusion (psychosis) may have more symptoms. Consult with your psychiatrist before taking this medicine.
  • Feeling sluggish or weak, headache, drowsiness, drowsiness or insomnia.
  • Dry mouth, change in taste, very rarely bleeding gums, salivation, mouth pain, bad breath, thirst. Dry mouth can cause cavities to develop earlier in your teeth. Therefore, brush and floss extra well if you notice that you suffer from dry mouth. If necessary, have your dentist check your teeth more often if you are taking this medication for several weeks.
  • Movement disorders, such as an uncertain gait when walking, balance problems, tendency to fall. Writing or other tasks requiring fine motor skills may also become more difficult and sloppy. Consult your doctor if you notice this.
  • Double vision, blurred vision and other vision problems. Very rarely dry eyes, or increased tearing. Very rarely increases in eyeball pressure, especially during the first month of use. Do you already suffer from green cataracts or glaucoma in one or both eyes? If so, consult with your doctor about additional monitoring by the ophthalmologist.
  • Tinnitus, earache, deafness.
  • Stuffy nose, runny nose, bloody nose, cough.
  • Skin rash, itching, hair loss. Very rarely skin discoloration.
  • Muscle and joint pain, muscle cramping. Very rarely stiff muscles.
  • Problems with urination, such as frequent small bouts of urination, pain when urinating. Rarely, kidney stones may develop. You can prevent this by drinking enough. For adults this is 2 liters per day. Very rarely, incontinence develops.

Very rarely

  • Impotence, less desire to have sex, more difficult orgasm.
  • Impaired sense of smell, trouble smelling.
  • Inflammation of the pancreas or liver and blood disorders. With sudden severe pain in the upper abdomen, jaundice, unexplained bruising, extreme fatigue or sore throat with fever and blisters in the throat you should call a doctor immediately.
  • Hypersensitivity to this medicine. You will notice this by a rash, hives or itching. If this happens, consult your doctor.
  • In very rare cases, a serious skin condition with blistering may occur. The blisters occur particularly on the lips and on the mucous membranes of the mouth and genitals. In this case, you should immediately seek a doctor or go to the First Aid Center.
  • If you are hypersensitive to this medicine you should not use it in the future. Tell the pharmacist that you are hypersensitive to topiramate. The pharmacy team can then make sure you do not get the medicine again.
  • Consult your doctor if you are overly bothered by any of the above side effects or if you experience other side effects that worry you.

Consult your doctor if you experience excessive amounts of any of the above side effects or if you experience other side effects that you are concerned about.

Explanation frequencies
Regular: in more than 30 out of 100 people
Uncommon: in 10 to 30 in 100 people
Rare: in 1 to 10 in 100 people
Very rarely : in less than 1 in 100 people

topamax healing nerves cells

Does Topamax interact with other medicines?

This medicine interacts with many other medicines. The text below usually only lists the active ingredients of these medicines, not the brand names. You can check whether your medicine contains any of these active substances in your package leaflet under the heading "composition".

The drugs with which the most important interactions occur are the following.

  • Birth control pill. Topiramate reduces the reliability of the pill. This increases the risk of pregnancy. Your doctor may replace topiramate with another medicine. Or you may be given another method of birth control, such as an IUD or the oral contraceptive pill. If this is not possible, you can use condoms. When you stop taking topiramate, the effect on hormones is still present for four weeks. Therefore, use condoms during and up to four weeks after stopping topiramate.
  • Please note that the vaginal ring and the contraceptive patch also become less reliable due to topiramate. Consult with your doctor about this.
  • Lithium, a medication for mania and depression. The amount of lithium in the blood may increase. This may increase side effects such as gastrointestinal problems, tremors, muscle weakness, muscle twitching, dizziness, drowsiness, drowsiness, confusion, decreased concentration, difficulty walking and speaking, and seizures. Alert your doctor immediately if you experience any of these side effects.
  • Some medicines for HIV. Ask your pharmacist which medications these are.

The medicines listed below reduce the effect of topiramate. If you need to take these medicines, your doctor will additionally check the effect of topiramate and adjust the dosage of topiramate.

  • The other medicines for epilepsy carbamazepine, phenobarbital, phenytoin and primidone.
  • Bosentan, a medication used in pulmonary arterial hypertension and in scleroderma.
  • Rifabutin and rifampicin, antibiotics for tuberculosis.

Are you unsure if any of the above interactions are important to you? If so, contact your pharmacist or doctor.

If I use Topamax, can I...

Drive a car?
Please note that if you have epilepsy, you are often not allowed to drive. Whether you can drive depends on certain test requirements. Consult your doctor about this. There is also a brochure "Epilepsy and fitness to drive" from the Epilepsy Fund. Want more information about driving with certain conditions? Then check out the CBR website.
Has your doctor determined that you may drive with your condition? Then do so only if you no longer suffer from the side effects of topiramate, such as drowsiness, fatigue, dizziness, impaired coordination, problems with memory and concentration, confusion and double vision. These side effects can make it dangerous to participate in traffic while taking this medication. Therefore, you should not drive for at least the first week that you are taking this medication. Also do not drive a car while the dose is still going up. Only after you have used the same dosage for 1 week may you drive again. But only if your doctor has given permission and you are no longer bothered by the side effects.
For more general information you can read the topic "Medicines in traffic". In this topic you can read, for example, what the law says about medicines in traffic. You will also find advice on what to take into account when you are allowed to drive.

Drink alcohol?
Alcohol increases the narcotic effect of this medicine. Even if you have not noticed this side effect, alcohol consumption can make you drowsy and can impair your coordination and judgment.

Eat anything?
There are no restrictions for this with this medicine.

Can I use Topamax if I am pregnant or breastfeeding?

Discuss your desire for children with your doctor before you are pregnant. If you are already pregnant, you should contact your doctor immediately. This is because using this medicine during pregnancy increases the risk of birth defects in the baby. But an epileptic seizure can also harm the baby. Therefore, discuss the pros and cons with your doctor.

Good monitoring during pregnancy is important. Sometimes it is necessary to measure the amount of the drug in the blood and adjust the dosage.

In any case, use folic acid from one month before you want to become pregnant until 2 months after you have become pregnant. You will thereby reduce the risk of birth defects.


If you want to breastfeed, consult your doctor. This medicine passes into breast milk. It is not known if this is harmful to the baby. Your doctor may be able to (temporarily) prescribe another medication that is known to be safe for you to use.

If you do have to use this medication and want to continue breastfeeding, it is important to monitor the baby closely for unwillingness to drink properly, vomiting, drowsiness and irritability.

Are you taking a combination of epilepsy drugs? If so, do not breastfeed. It appears that combinations of epilepsy drugs are more likely to cause side effects in the infant such as unwillingness to drink properly, vomiting, drowsiness and irritability.

What should I do if I forget a dose?

It is important to take this medicine consistently. If you do forget a dose, take the forgotten dose as soon as possible. However, never take a double dose. With this medicine, overdosing quickly has harmful effects. You can shift the next dose if necessary. Ask your doctor for advice.

Can I just stop taking Topamax?

You cannot stop just like that. Always consult your doctor if you want to stop. The dose must be reduced slowly, otherwise severe seizures may occur. This may take several months. Do you have to stop because you are hypersensitive or have serious side effects? Do stop immediately and call a doctor immediately. Even if you start taking another epilepsy medication, you should not stop taking this medication at once. First, you will use the second medicine alongside it in gradually increasing doses. If all this goes well, you can gradually phase out the first drug in consultation with the doctor.


This text has been prepared by the Medicines Information Centre of the KNMP. This text is based on the package leaflet of the medicine described and on other, scientific sources. The officially registered details of this medicine with the Medicines Evaluation Board can be found at: Although the utmost care has been taken in drafting the text, KNMP is not liable for any damage that may arise from any inaccuracy in this text.


  • be careful with alcohol
  • can impair responsiveness

Active substance

  • topiramate


  • lactose 1-water
  • cornstarch, pre-gelatinized
  • cellulose, microcrystalline
  • carboxymethyl starch sodium
  • magnesium stearate
  • carnauba wax
  • hypromellose
  • macrogol (molecular weight unknown)
  • polysorbate 80
  • titanium dioxide


  • reimbursed via health insurance if on prescription
  • preference policy not applicable

Topamax Price

Topamax Price

Online prices of Topamax are relatively lower. The cost of topiramate at an online pharmacy depends largely on the quantity of packages of the drug ordered. If you want to order topiramate cheaply from pharmacies, opt for an inexpensive large package.

Topamax price per box

CPR 100 mg 200 mg
30 $87.55 $155.72
60 $145.56 $252.27
90 $203.56 $348.82
120 $261.56 $445.37
180 $377.57 -

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