Topiramate

What is Topiramate

Topiramate is an oral antiepileptic drug (AED) used for partial-onset, generalized primary tonic-clonic seizures, and as an adjunct therapy in Lennox-Gastaut syndrome.

It is derived from the naturally occurring monosaccharide D-fructose and is structurally different from other AEDs. Unlike other AEDs, topiramate appears to block the spread of seizures rather than raise the seizure threshold.

Topiramate possesses more than one mechanism of action, which may explain why it can be effective in patients with various seizures that are refractory to other agents.

Topiramate continues to be studied as both add-on therapy and monotherapy in various refractory epilepsies in children and adults, including infantile spasms associated with West syndrome. It is also used for migraine prophylaxis in adult and pediatric patients.

There is some evidence of a role for topiramate treatment ‘off-label’ for eating disorders such as binge-eating disorder, for tics due to Tourette’s syndrome or other chronic tic disorders, or for substance abuse disorders such as alcohol dependence

Indications

  1. absence seizures
  2. alcohol dependence
  3. atonic seizures
  4. binge-eating disorder
  5. bipolar disorder
  6. bulimia nervosa
  7. cocaine dependence
  8. diabetic neuropathy
  9. infantile spasms
  10. Lennox-Gastaut syndrome
  11. migraine prophylaxis
  12. myoclonic seizures
  13. partial seizures
  14. short-lasting unilateral neuralgiform headache with conjunctival injection and tearing
  15. tonic-clonic seizures
  16. Tourette’s syndrome

For the treatment of partial seizures (monotherapy or adjuvant therapy)

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. acute cerebellar syndrome
  4. agitation
  5. alopecia
  6. amenorrhea
  7. anemia
  8. angina
  9. anorexia
  10. anxiety
  11. aphasia
  12. appetite stimulation
  13. arthralgia
  14. arthropathy
  15. asthenia
  16. ataxia
  17. AV block
  18. back pain
  19. bleeding
  20. blurred vision
  21. bradycardia
  22. breast discharge
  23. bronchospasm
  24. bullous rash
  25. candidiasis
  26. chest pain (unspecified)
  27. confusion
  28. conjunctivitis
  29. constipation
  30. cough
  31. cystitis
  32. dehydration
  33. delirium
  34. depression
  35. diabetes mellitus
  36. diarrhea
  37. diplopia
  38. dizziness
  39. drowsiness
  40. drug-induced body odor
  41. dysarthria
  42. dysgeusia
  43. dyskinesia
  44. dyspepsia
  45. dysphagia
  46. dysphonia
  47. dyspnea
  48. dystonic reaction
  49. ecchymosis
  50. edema
  51. EEG changes
  52. ejaculation dysfunction
  53. elevated hepatic enzymes
  54. emotional lability
  55. encephalopathy
  56. eosinophilia
  57. epistaxis
  58. erythema multiforme
  59. esophagitis
  60. euphoria
  61. fatigue
  62. fecal incontinence
  63. fever
  64. flatulence
  65. flushing
  66. gastritis
  67. gastroesophageal reflux
  68. gingival hyperplasia
  69. gingivitis
  70. glossitis
  71. growth inhibition
  72. hallucinations
  73. headache
  74. hearing loss
  75. hematoma
  76. hematuria
  77. hemorrhoids
  78. hepatic failure
  79. hepatitis
  80. hot flashes
  81. hyperammonemia
  82. hyperchloremic acidosis
  83. hyperemia
  84. hyperesthesia
  85. hyperglycemia
  86. hyperhidrosis
  87. hyperkinesis
  88. hyperlipidemia
  89. hypernatremia
  90. hypersalivation
  91. hypertension
  92. hyperthermia
  93. hyperthyroidism
  94. hypertonia
  95. hypertrichosis
  96. hypocalcemia
  97. hypoesthesia
  98. hypoglycemia
  99. hyponatremia
  100. hypophosphatemia
  101. hyporeflexia
  102. hypotension
  103. hypothermia
  104. impotence (erectile dysfunction)
  105. increased urinary frequency
  106. infection
  107. insomnia
  108. involuntary movements
  109. iritis
  110. irritability
  111. lacrimation
  112. laryngitis
  113. leukopenia
  114. leukorrhea
  115. libido decrease
  116. libido increase
  117. lymphadenopathy
  118. lymphocytosis
  119. lymphopenia
  120. mania
  121. melasma
  122. melena
  123. memory impairment
  124. menorrhagia
  125. menstrual irregularity
  126. metabolic acidosis
  127. migraine
  128. muscle cramps
  129. myalgia
  130. mydriasis
  131. myopia
  132. nausea
  133. nephrolithiasis
  134. nocturia
  135. nystagmus
  136. ocular hypertension
  137. ocular pain
  138. oligohidrosis
  139. oliguria
  140. orthostatic hypotension
  141. osteomalacia
  142. osteoporosis
  143. pallor
  144. pancreatitis
  145. pancytopenia
  146. paranoia
  147. paresthesias
  148. parosmia
  149. pemphigus
  150. peripheral neuropathy
  151. peripheral vasodilation
  152. pharyngitis
  153. phlebitis
  154. photophobia
  155. photosensitivity
  156. polycythemia
  157. polydipsia
  158. polyuria
  159. pruritus
  160. psychomotor impairment
  161. psychosis
  162. ptosis
  163. pulmonary embolism
  164. purpura
  165. rash
  166. rhinitis
  167. scotomata
  168. seborrhea
  169. secondary malignancy
  170. seizures
  171. sinusitis
  172. skin discoloration
  173. Stevens-Johnson syndrome
  174. stomatitis
  175. suicidal ideation
  176. syncope
  177. thrombocytopenia
  178. thrombocytosis
  179. thrombosis
  180. tinnitus
  181. toxic epidermal necrolysis
  182. tremor
  183. urinary incontinence
  184. urinary retention
  185. urticaria
  186. vaginal bleeding
  187. vertigo
  188. visual impairment
  189. vomiting
  190. weight gain
  191. weight loss
  192. xerophthalmia
  193. xerosis
  194. xerostomia

Monitoring Parameters

  • serum bicarbonate
  • serum creatinine/BUN
  • serum electrolytes

Contraindications

  • abrupt discontinuation
  • ambient temperature increase
  • autoimmune disease
  • bleeding
  • breast-feeding
  • children
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • contraception requirements
  • depression
  • diabetes mellitus
  • dialysis
  • diarrhea
  • driving or operating machinery
  • emphysema
  • encephalopathy
  • females
  • geriatric
  • glaucoma
  • growth inhibition
  • hepatic disease
  • hypertension
  • increased intraocular pressure
  • infants
  • labor
  • metabolic acidosis
  • mitochondrial disease
  • neonates
  • nephrolithiasis
  • ocular disease
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • reproductive risk
  • status asthmaticus
  • status epilepticus
  • suicidal ideation
  • surgery
  • thrombocytopenia
  • visual disturbance

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abciximab
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Tramadol
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alprazolam
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amphetamines
  • Anagrelide
  • Anticholinergics
  • Antithrombin III
  • Anxiolytics; Sedatives; and Hypnotics
  • Apixaban
  • Aprepitant, Fosaprepitant
  • Argatroban
  • Aripiprazole
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atovaquone; Proguanil
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Barbiturates
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Benzodiazepines
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bivalirudin
  • Boceprevir
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bumetanide
  • Bupivacaine; Lidocaine
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Canagliflozin; Metformin
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Cariprazine
  • Celecoxib
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorothiazide
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpromazine
  • Choline Salicylate; Magnesium Salicylate
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clonazepam
  • Clorazepate
  • Cobicistat
  • Cobimetinib
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • Conjugated Estrogens; Medroxyprogesterone
  • Dabigatran
  • Dapagliflozin; Metformin
  • Dapsone
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desipramine
  • Desirudin
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Diazepam
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dienogest; Estradiol valerate
  • Diflunisal
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dipyridamole
  • Dolutegravir
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Doravirine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Doxepin
  • Doxorubicin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Edoxaban
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Elvitegravir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eptifibatide
  • Ertugliflozin; Metformin
  • Esomeprazole; Naproxen
  • Estazolam
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estrogens
  • Ethacrynic Acid
  • Ethanol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Etodolac
  • Etonogestrel
  • Ezogabine
  • Famotidine; Ibuprofen
  • Felbamate
  • Fenoprofen
  • Flibanserin
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • food
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Furosemide
  • Gefitinib
  • Glimepiride; Pioglitazone
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Heparin
  • Homatropine; Hydrocodone
  • Hydantoins
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxychloroquine
  • Hydroxyprogesterone
  • Hydroxyzine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Imatinib
  • Imipramine
  • Indomethacin
  • Isavuconazonium
  • Ivabradine
  • Ketoprofen
  • Ketorolac
  • Lacosamide
  • Lamotrigine
  • Lansoprazole; Naproxen
  • Lepirudin
  • Leuprolide; Norethindrone
  • Levetiracetam
  • Levonorgestrel
  • Lidocaine
  • Lidocaine; Prilocaine
  • Linagliptin
  • Linagliptin; Metformin
  • Lithium
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorazepam
  • Low Molecular Weight Heparins
  • Lumateperone
  • Lurasidone
  • Magnesium Salicylate
  • Maprotiline
  • Maraviroc
  • Meclofenamate Sodium
  • Medroxyprogesterone
  • Mefenamic Acid
  • Mefloquine
  • Meloxicam
  • Meperidine; Promethazine
  • Mesoridazine
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methenamine
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Midazolam
  • Molindone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nisoldipine
  • Nonsteroidal antiinflammatory drugs
  • Norethindrone
  • Norgestrel
  • Nortriptyline
  • Ombitasvir; Paritaprevir; Ritonavir
  • Oxaprozin
  • Oxazepam
  • Oxycodone
  • Paroxetine
  • Pazopanib
  • Pemoline
  • Pentosan
  • Perampanel
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Pioglitazone
  • Piroxicam
  • Prasugrel
  • Pregabalin
  • Probenecid
  • Prochlorperazine
  • Progesterone
  • Progestins
  • Promethazine
  • Protriptyline
  • Quazepam
  • Ramelteon
  • Rilpivirine
  • Ritonavir
  • Rivaroxaban
  • Rofecoxib
  • Romidepsin
  • Rufinamide
  • Salicylates
  • Salsalate
  • Segesterone Acetate; Ethinyl Estradiol
  • Sertraline
  • Simeprevir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Sufentanil
  • Sulindac
  • Telithromycin
  • Temazepam
  • Terbinafine
  • Thiethylperazine
  • Thioridazine
  • Thrombin Inhibitors
  • Tiagabine
  • Ticagrelor
  • Ticlopidine
  • Tirofiban
  • Tolmetin
  • Tolterodine
  • Tolvaptan
  • Torsemide
  • Tramadol
  • Tretinoin, ATRA
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Trospium
  • Ulipristal
  • Valdecoxib
  • Valproic Acid, Divalproex Sodium
  • Vemurafenib
  • Vorapaxar
  • Warfarin
  • Zonisamide
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top