Topiramate

Topiramate belongs to a group of medicines called anti-epilepsy medicines, which are used to treat various types of epilepsy.

Topiramate is licenced for use on its own to treat adults and children aged six years or older. It can also be used in combination with other anti-epileptic medicines in both adults and children aged two years or older. It is available in various strengths of tablets and as a sprinkle formulation used mainly for children. Topiramate is also available under the brand name Topamax®.

How is it given?

Your doctor will usually start with a low dose and slowly increase the dose to the lowest amount needed to control the seizures.

  • Tablets should be swallowed with plenty of water. They can be taken with or without food.

  • The sprinkle formulation comes in capsules, which should be opened and sprinkled onto food.

  • Do not stop the medicine without checking with your doctor. 

Are there any side effects?

Each person reacts differently to medicines, so your child will not necessarily suffer from every side effect mentioned and may not experience any side effects. If you are concerned, please ask your doctor, nurse or pharmacist on the contact number below.

  • The most common side effects are headaches, difficulty with concentration, dizziness, tiredness, mood swings, anxiety and depression, loss of appetite, nausea and weight loss.

  • Occasionally children experience a slowing down of their thought process and speech, which resolves on reducing the dose or stopping the drug.

  • Less frequent side effects are kidney stones (mainly in adults), blurring of vision and eye pain. 

Please inform the doctor immediately if your child experiences any of these side effects. 

Topiramate and other medicines

  • Paracetamol (Calpol® or Disprol® amongst others) and most other over-the-counter medicines can be safely taken with topiramate. Over the counter medicines are those that can be bought without a prescription.

  • Antibiotics can be taken with topiramate.

  • Topiramate may reduce the effect of the contraceptive pill.

  • Topiramate can be taken with other anti-epilepsy medicines. However, in some cases, the effectiveness can be increased or reduced. Your doctor will adjust the doses accordingly. 

Important information

  • Always give the medicine as prescribed by your doctor.

  • In certain circumstances, medicines may be prescribed for a child outside the age range recommended by the manufacturer. Medicines are often used off-licence in children because trial data is not available for a specific use, for example, age. This is not necessarily hazardous but should be explained and agreed before use. Your doctor will explain this further to you.

  • Where possible, make sure that the same brand is always used as the effectiveness can vary from one brand to another.

  • Always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines.

  • If you miss a dose of the medicine and you remember up to four hours afterwards, give the forgotten dose immediately. If you remember at or near the time that the next dose is due, just give your child the usual dose.

  • If your child vomits within a short time of taking a dose and you are able to see the tablet in the vomit, then give the dose again. If you cannot see the tablet, do not give it again.

  • If your child has been taking the medicine regularly, do not stop it suddenly without advice. Your doctor may need to reduce the dose gradually.

  • If your child stops using a medicine or it passes its expiry date, please return it to your pharmacist. Do not flush it down the toilet or throw it away.

  • Some anti-epilepsy medicines can affect how well the contraceptive pill works. Please discuss this with your doctor.

  • Some anti-epilepsy medicines can affect an unborn baby if taken during pregnancy. Please discuss this with your doctor.

  • Keep medicines in a safe place where children cannot see or reach them.

  • Keep medicines at room temperature, away from bright light or direct sunlight, and away from heat.

  • Always check that you have enough medicine and remember to order a new prescription in plenty of time.

Compiled by: 
The National Centre for Young People with Epilepsy, GOSH Epilepsy Service and GOSH Pharmacy department in collaboration with the Child and Family Information Group, GOSH.
Last review date: 
May 2016
Ref: 
2016F0742

Disclaimer

Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.

For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.  

For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.