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Topiramate - Indications, Dosage, Side Effects and Precautions

Written & Compiled by Anushta Chandrapalan, M.Sc  | Medically Reviewed by The Medindia Medical Review Team
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General Information on Topiramate

Generic Name : Topiramate
Pronunciation : toe-PIR-a-mate
Latest prescription information about Topiramate. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, warnings and its storage instructions . Also listed are the International and Indian trade name(s) of the drug and its price list.
ICD Code : Y46.6 | Therapeutic Classification : Anticonvulsants

Trade Names/Brand Names of Topiramate

India : 

International : 


Why is Topiramate Prescribed? (Indications)

This medication is an anticonvulsant, prescribed for the treatment of seizures and prevents migraine headaches, either alone or with other medications. It decreases abnormal excitement in the brain. 

When should Topiramate not be taken? (Contraindications)


What is the dosage of Topiramate?

When used alone, the starting dose is 25 mg/ night taken orally. The dose may be increased after 1 week to a maximum of 400 mg/day. When used in combination, dose may be increased to a maximum of 800 mg/day. It is also used to prevent migraine with a similar starting dose. It may be increased to 25 to 50 mg twice a day.

How should Topiramate be taken?

It comes as a tablet, capsule, to take by mouth, with or without food twice a day in the morning and evening.

What are the warnings and precautions for Topiramate?

Caution should be exercised in patients with history of liver or kidney problems, during pregnancy.

It may cause drowsiness, dizziness, confusion, or trouble in concentration, avoid driving or operating machinery while taking this medication.

Avoid activities such as swimming, driving, and climbing.

Drink adequate water to reduce the risk of kidney stone especially in predisposed patients.

Measure serum bicarbonate at baseline and periodically during treatment.

Monitor closely for decreased sweating and increased body temperature, especially in hot weather.

What are the side effects of Topiramate?

  Heart: Hypertension, slow heart beat.
  Central Nervous System: Tingling, drowsiness, nervousness, confusion, difficulty with concentration, dizziness, fatigue,difficulty with memory, depression, speech disorders, behavior problems, abnormal gait, anxiety, abnormal coordination,mood problems, language problems, aggressive reaction, sleeplessness, tremor, involuntary muscle contraction, agitation.
  Skin: Hair loss, itching, rash, acne, skin disorder, dermatitis, redness of the skin, eczema, increased sweating, seborrhea, skin discoloration.
  Eye and ENT: Abnormal tears , eye pain,double vision, blurred vision, conjunctivitis, eye abnormality, tinnitus, abnormal accommodation, decreased hearing, inflammation of the middle ear, tinnitus, inflammation of pharynx.
  Gastrointestinal: Loss of appetite, nausea, diarrhea, abdominal pain, difficulty in swallowing, increased saliva, constipation, dry mouth, gas,fecal incontinence, gingivitis, inflammation of the tongue, gum hyperplasia, tooth disorder, inflammation of pancreas.
  Genitourinary: Breast pain, urinary incontinence, urinary tract infection, cyst in urine, menstrual disorder, premature ejaculation, kidney stone, vaginal bleeding; absence of menstrual cycle, frequency, prostate disorder, intermenstrual bleeding, acid in urine tube.
  Blood: Multiple bleeding, nose bleed, decrease in hemoglobin, white blood cells, blood clot.
  Liver: Gamma-GT increased, liver failure, jaundice.
  Metabolic: Loss of weight, thirst, low blood sugar, increased appetite.
  Musculoskeletal: Joint pain, leg cramps, muscle pain.
  Respiratory: Upper respiratory tract infection, runny nose, pneumonia, coughing, difficulty in breathing, asthma, respiratory disorder.
  Miscellaneous: Injury, fever, viral infection, back pain, chest pain, flu-like symptoms, leg pain, allergic reaction, hot flushes, neoplasm, body odor, rigors, skeletal pain.

What are the other precautions for Topiramate?

Avoid abrupt withdrawal.
Seek immediate medical attention if blurred vision or eye pain.

What are the storage conditions for Topiramate?

Oral: Store at 15-30C. Store it in an airtight container and keep away from children.

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HEM66, India

This medicine must not be prescribed for weight loss. I have taken it for one and a half months and the other side effects like asthma are severe.

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