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Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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Healthcare professionals are reminded that topiramate must be prescribed according to current guidance. In addition, females of childbearing potential or their carers should be counselled on the importance of avoiding pregnancy due to these emerging risks, as well as the established risks associated with topiramate use in pregnancy. See also Conception and contraception, and Pregnancy. Avoid in Acute porphyrias ; risk of metabolic acidosis; risk of nephrolithiasis—ensure adequate hydration especially in strenuous activity or warm environment. Abnormal sensation in eye; anhidrosis; arrhythmias; aura; cerebellar syndrome; consciousness impaired; crying; drooling; dry eye; dysgraphia; dysphonia; eosinophilia in children ; facial swelling; hallucinations; hearing impairment; hyperthermia in children ; hypokalaemia; hypotension; influenza like illness; learning disability in children ; leucopenia; lymphadenopathy; metabolic acidosis; musculoskeletal stiffness; palpitations; pancreatitis; paranasal sinus hypersecretion; peripheral coldness; peripheral neuropathy; polydipsia; psychotic disorder; renal pain; sexual dysfunction; smell altered; suicidal behaviours; syncope; thinking abnormal; thirst; thrombocytopenia; vasodilation. Eye inflammation; face oedema; glaucoma; hepatic disorders; limb discomfort; neutropenia; Raynaud's phenomenon; renal tubular acidosis; severe cutaneous adverse reactions SCARs ; unresponsive to stimuli. If raised intra-ocular pressure occurs: seek specialist ophthalmological advice; use appropriate measures to reduce intra-ocular pressure and stop topiramate as rapidly as feasible. M See Prescribing in renal impairment. Indications and dose For topiramate Monotherapy of generalised tonic-clonic seizures or focal seizures with or without secondary generalisation for topiramate By mouth Child 6—17 years Initially 0. Adult Initially 25 mg once daily for 1 week, dose to be taken at night, then increased in steps of 25—50 mg every 1—2 weeks, dose to be taken in 2 divided doses; usual dose — mg daily in 2 divided doses, adjusted according to response, doses of 1 g daily have been used in refractory epilepsy; maximum mg per day.

Patients, in whom epileptic seizures are combined with migraine attacks, can buy Topamax and use it both as a monotherapy and in combination with other drugs. Tablets must be taken whole, without chewing, and with plenty of water. Sprinkle capsules can be taken both whole and mixed with a liquid or food. The dosage of Topamax is selected individually for each patient. For optimal control of epileptic seizures, it is recommended to begin treatment with low Topamax doses with subsequent increase to the maximum therapeutic level.

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