Topamax Precautions and Warnings

Topamax can have a drug interaction with other medicines or not be a good drug for you if you have certain medical conditions. It’s important to know all of the medicines that you or your family member takes. Use the migraine journal to keep a list of all medicines to share with your doctor. Only your doctor can prescribe prescription medicines for you. Do not stop taking any medicine without speaking to your doctor.

Topamax can cause serious side effects including:

  • Hyperammonemia (high levels of ammonia in the blood)
  • Metabolic acidosis (increased acid levels in the body)

Learn more about Topamax Drug Interactions here.

  • Encephalopathy (brain disease, damage, or other problems)
  • Secondary angle closure glaucoma (fluid buildup inside of the eye, which can lead to blindness)
  • Sudden problems with vision (difficulty seeing clearly)

Learn about Topamax and Serious Eye Problems (including Open Angle Glaucoma)

Topamax is not recommended if you:

  • Have an extreme sensitivity to topiramate (the active ingredient in Topamax formulations). This could lead to reactions from severe itching and hives to potentially deadly shock.


Topamax should be used with caution if you:

  • Have or have had kidney problems, including kidney stones
  • Are over the age of 65


People with these conditions or circumstances may need to take a lower dose of Topamax or take special tests to use Topamax safely.

CAUTION: Do not suddenly stop taking Topamax.

This may cause serious health problems or side effects such as increase or return of seizures. Topamax should be withdrawn gradually by reducing the dose at weekly intervals if the decision is made by the physician to discontinue therapy.


Topamax and Kidney Problems

Taking Topamax may increase the possibility of your developing kidney stones. It may also increase your risk of developing metabolic acidosis (when the kidneys aren’t removing enough acid from the body).

Your risk of kidney problems is greater if:

  • You have a history of kidney stones, kidney problems, or metabolic acidosis
  • You do not drink enough fluids every day

People taking Topamax may need to have their kidney function checked while they are taking this drug.

Make sure you drink plenty of fluids throughout the day, especially while you are taking Topamax. This can help prevent kidney stones from developing while taking Topamax.


Topamax and Driving or Operating Heavy Machinery

Because Topamax may cause sleepiness, fatigue, coordination problems, and other difficulty with movement, you should not operate dangerous machinery, including automobiles, until you are reasonably sure that your medicine is not affecting you in these ways.

If you frequently become sleepy while taking Topamax, talk with your doctor about reducing your dosage. Never change or stop your dosage of a medicine without first talking with your doctor.


Topamax and Drug Abuse and Dependence

Experts have not studied whether Topamax can lead to abuse, tolerance, or physical dependence. Let your doctor know if you have had any drug abuse or misuse in the past. If so, your doctor should follow your treatment very closely if you begin taking Topamax.


Topamax and Alcohol

Topamax can cause sleepiness or dizziness. Drinking alcohol while taking Topamax can make these side effects worse. For this reason, you should not drink alcohol while taking this drug.

Remember: Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don’t know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or doctor.


Learn more on Topamax Special Warnings.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
View References