Topiramate oral tablet side effects: A detailed guide

This article describes possible side effects of topiramate oral tablet. You’ll also find information on cost savings and coupon options for topiramate.

Topiramate oral tablet is a generic version of the brand-name drug Topamax. Topiramate also comes in other forms that you’ll swallow or sprinkle on food, but these forms aren’t described in this article. To learn more about these forms, talk with your doctor.

You can explore this overview article to learn more about topiramate oral tablet, including the drug’s uses, dosage, ways to save on cost, and more.

More common side effects of topiramate

Topiramate oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of topiramate oral tablet include:

• fatigue (low energy)
• lack of appetite
• nausea
• tingling or prickling sensations in the hands, arms, legs, or feet
• weight loss*

* To learn more about this side effect, see the “Side effects of topiramate in detail” section below.

Mild side effects of topiramate

Topiramate may cause certain mild side effects. Usually, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of topiramate oral tablet that occurred in studies include:

• abdominal (belly) pain
• changes in the sense of taste
• diarrhea
• dizziness
• fatigue (low energy)
• fever
• lack of appetite
• difficulty with memory
• nausea
• nervousness
• decreased sense of touch
• sleepiness
• slow reactions that affect thinking or movement
• speech problems, such as difficulty finding words to say
• tingling or prickling sensations in the hands, arms, legs, or feet
• upper respiratory infection, such as sinus infection or common cold
• hair loss*
• weight loss*
• mild allergic reaction*†

* To learn more about this side effect, see the “Side effects of topiramate in detail” section below.
† An allergic reaction is possible with topiramate oral tablet. But it wasn’t reported in the drug’s studies.

Topiramate oral tablet may cause more mild side effects than those listed above. For more details, see the drug’s prescribing information.

Serious side effects of topiramate

Topiramate may cause certain serious side effects. If you have any serious side effects from topiramate oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911, or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with topiramate oral tablet.

Serious side effects of topiramate oral tablet that occurred in studies include:

• buildup of acid in the body
• decreased sweating, which may lead to increases in body temperature
• glaucoma and other eye or vision problems
• high levels of ammonia in the blood, which can lead to problems with brain function
• kidney stones
• severe changes in thinking, mood, personality, or behavior
• suicidal thoughts or behaviors
• serious skin-related side effects*
• severe allergic reaction*†

* To learn more about this side effect, see the “Side effects of topiramate in detail” section below.
† An allergic reaction is possible with topiramate oral tablet. But it wasn’t reported in the drug’s studies.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Side effects of topiramate in children

In children, topiramate is approved to:

• treat certain seizures in children ages 2 years and older
• help prevent migraine in children ages 12 years and older

Most of topiramate’s side effects are similar in adults and children. But there are some serious side effects that are unique to children, including:

• decreased bone mineral density, which can lead to weakened bones
• slowed growth in height and weight

In studies, decreased sweating was more common in children compared with adults. It led to increases in body temperature and overheating.

Common questions about side effects of topiramate

Here are answers to some common questions about side effects of topiramate oral tablet. If you have other questions, talk with your doctor or pharmacist.

Is topiramate safe to take?

Yes. Studies have shown that topiramate is safe and effective in adults and certain children. It’s used to treat certain kinds of seizures and help prevent migraine. As with any drug, topiramate isn’t suitable for everyone.

For some people, other drugs may be better treatment options. That’s why it’s important to talk with your doctor about your medical history and any medications you take before starting topiramate.

Tell your doctor if you have concerns about taking topiramate. Ask about all possible treatment options and their risks and benefits.

How do side effects of topiramate 25 mg compare with side effects of topiramate 50 mg?

Most of topiramate’s side effects depend on different doses. This means they may be more common or more severe at higher doses.

So, it’s possible to have more side effects or more bothersome side effects if your doctor increases the dose. An example would be increasing a dose from 25 milligrams (mg) to 50 mg.

That said, the side effects themselves don’t vary between topiramate doses.

If your doctor increases your dosage of topiramate and you notice new or worsening side effects, tell your doctor. They can suggest ways to manage side effects as your body adjusts to the new dosage.

Does topiramate cause long-term side effects?

In most cases, side effects of topiramate are temporary. They may last a few days or weeks and improve as your body gets used to the medication.

That said, some possible serious side effects may cause long-term outcomes. For example, topiramate can cause a type of glaucoma that can lead to blindness if it’s not treated.

In children, long-term use of topiramate can cause decreased bone density and slowed growth. To learn more, see the “Side effects of topiramate in children” section above.

For more information about long-term topiramate treatment, talk with your doctor. Ask about whether it’s safe for you to take this drug long term.

Coupon for topiramate

Visit this page to access Optum Perks coupons and get price estimates for topiramate when you use the coupons. These coupons can provide significant savings on your prescription costs.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Side effects of topiramate in detail

Below you’ll find details on some of the side effects of topiramate oral tablet.

Weight loss

Weight loss is a very common side effect reported in studies of topiramate. It can occur in adults and children taking the drug. In children, weight loss can be a sign of slowed growth.

Ways to manage

Doctors will monitor the height and weight of children taking topiramate. If a child is experiencing slowed growth, their doctor may recommend changing to a different treatment.

If you notice unintended weight loss while taking topiramate, be sure to tell your doctor. They can help you determine the most likely cause of your weight loss and suggest ways to manage it. They can also suggest ways to help you reach or maintain a body weight that’s healthy for you.

Skin-related side effects

Serious skin-related side effects are possible with topiramate. This includes Stevens-Johnson syndrome and toxic epidermal necrolysis. Symptoms of these side effects include:

• blisters
• peeling skin
• severe, widespread rash

These serious skin reactions can become life threatening without treatment. In some cases, serious skin reactions can happen due to an allergic reaction to topiramate. For more information about this, see the “Allergic reaction” section below.

Ways to manage

If you develop a rash while taking topiramate, call your doctor immediately. If the rash has any of the symptoms listed above, seek emergency medical care or call 911.

Hair loss

Hair loss is a possible side effect of topiramate. It was reported as a common side effect in the drug’s studies.

Ways to manage

If you notice hair loss while taking topiramate, talk with your doctor. They may suggest ways to manage this side effect or recommend treatment options other than topiramate.

Allergic reaction

For some people, topiramate oral tablet can cause an allergic reaction. But this side effect wasn’t reported in the drug’s studies.

Symptoms can be mild or serious, and they may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, that can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

In addition, very rare but serious skin reactions can occur due to an allergic reaction. Rare cases of these skin reactions were reported in people receiving topiramate. These reactions are life threatening and can be fatal. They may cause widespread rash or blistering skin. The serious skin reactions include:

• Stevens-Johnson syndrome
• toxic epidermal necrolysis

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know if you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling, trouble breathing, or serious skin reaction, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to topiramate oral tablet, your doctor may recommend taking a different medication instead.

Warnings for topiramate

Below are some factors you may want to discuss with your doctor before taking topiramate oral tablet.

Warnings

It may not be safe for you to take topiramate oral tablet if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether topiramate oral tablet is a safe treatment option for you.

Before taking topiramate oral tablet, tell your doctor about your health and medications you take. Things to consider include those listed below.

Allergic reaction. If you’ve had an allergic reaction to topiramate oral tablet or any of its ingredients, your doctor will likely not prescribe this medication. Ask them about other treatment options that may be better for you.

Bone problems. Taking topiramate increases the risk of metabolic acidosis. This condition is a buildup of acid in the body. Metabolic acidosis can cause a softening or weakening of the bones. If you have bone problems, such as osteoporosis, metabolic acidosis could make your bone condition worse.

Talk with your doctor about your bone health before starting topiramate. They can advise whether it is safe for you to take this drug.

Diarrhea. Having uncontrolled or frequent diarrhea may increase the risk of metabolic acidosis while taking topiramate. Before taking topiramate, tell your doctor if you have diarrhea. They can recommend whether it’s safe to take this drug. If they prescribe topiramate for you, they may also suggest monitoring with blood tests more than usual.

Glaucoma. Topiramate can cause problems with your eyes and vision. This includes secondary angle-closure glaucoma, which is a sudden increase in pressure inside your eye. If you have glaucoma, tell your doctor before starting topiramate. They can help determine whether topiramate is safe for you to take based on your eye health.

Ketogenic diet. Eating a ketogenic diet, which is high in fat and low in carbohydrates, is not recommended while taking topiramate. Doing so increases the risk of metabolic acidosis and kidney stones. If you’re following a ketogenic diet, talk with your doctor before starting topiramate. They may suggest other treatment options or diet plans.

Kidney problems. Having kidney disease or kidney problems while taking topiramate increases the risk of metabolic acidosis and kidney stones. Talk with your doctor about your kidney function before starting topiramate. They may closely monitor your kidney health while you’re taking this drug. They may also suggest a lower dose than usual or recommend a different treatment option.

Liver problems. Having liver problems may increase the risk of high blood ammonia levels while taking topiramate. Tell your doctor about any liver problems you have before starting topiramate. They may suggest monitoring with blood tests more than usual.

Lung problems. Having severe lung problems increases the risk of metabolic acidosis while taking topiramate. Tell your doctor about any lung problems you have before starting topiramate. Ask if this drug is right for you. If you take topiramate, your doctor may suggest monitoring with blood tests more than usual.

Mental health conditions. Topiramate can increase the risk of suicidal thoughts or behaviors. Tell your doctor if you or any family members have a history of mental health conditions. Examples include depression and suicidal thoughts or behaviors. Ask your doctor whether topiramate is right for you.

If your doctor prescribes topiramate for you, they’ll closely monitor your mental health. This includes watching for changes in your thoughts, moods, or behaviors. It can also be helpful to have a few loved ones watch for these changes.

Topiramate and pregnancy

It’s not safe to take topiramate during pregnancy. The drug can cause fetal harm. This includes problems with fetal development (also called birth defects), such as cleft lip or cleft palate.

Infants exposed to topiramate during pregnancy may have a low birth weight. This increases their risk of health problems later in life.

Because of this risk, doctors may not prescribe this drug to a pregnant person. But your doctor can recommend whether it’s safe for you.

If you’re pregnant or able to become pregnant, tell your doctor before taking topiramate. If you take it during pregnancy, you’re encouraged to enroll in the drug’s pregnancy registry. This registry collects information about topiramate treatment in pregnant people.

Topiramate and breastfeeding

Topiramate passes into breast milk. This means it may cause mild side effects in a child who is breastfed. Diarrhea and excessive sleepiness have been reported in children exposed to topiramate through breast milk.

Talk with your doctor about breastfeeding while taking topiramate. Together, you can weigh the risks and benefits and decide whether you should breastfeed while taking topiramate.

Topiramate and alcohol

No studies have examined whether topiramate and alcohol interact with each other. But there’s an increased risk of certain side effects when you consume alcohol during treatment with topiramate. These include:

• excessive sleepiness
• dizziness
• difficulty thinking
• changes in mood or behavior

Due to this risk, you should not consume alcohol while taking topiramate. If you have questions about the safety of alcohol during topiramate treatment, talk with your doctor.

What to ask your doctor

This article describes common and serious side effects of topiramate oral tablet. If your doctor prescribes this medication, they can discuss possible side effects with you. Tell your doctor if you have concerns or questions about treatment with this medication.

Here’s a list of some possible questions you may want to ask your doctor:

• Is there anything in my medical history that increases my risk of side effects from topiramate?
• How long do topiramate’s side effects usually last?
• What symptoms should I watch for that could mean I’m having a serious side effect?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.