Topiramate 25/50/100/200 mg Tablets
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about Topiramate AN (topiramate).
It does not contain all the available information.
It does not take the place of talking to your doctor or pharmacist.
This leaflet was last updated on the date at the end of this leaflet. More recent information may be available. The latest Consumer Medicine Information is available from https://www.ebs.tga.gov.au/ and may contain important information about the medicine and its use of which you should be aware.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking Topiramate AN against the benefits it is expected to have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What Topiramate AN is used for
The name of your medicine is Topiramate AN. Topiramate AN contains topiramate. Topiramate belongs to a group of medicines called antiepileptics. Topiramate prevents seizures and migraines by affecting chemicals in the brain that are involved in sending signals to the nerves.
Topiramate AN is used for the treatment of various types of epilepsy in adults and children over 2 years of age.
Topiramate AN is also used for the prevention of migraines in adults.
Your doctor may prescribe Topiramate AN on its own, or in combination with other medicine for controlling your seizures or migraines. Your doctor may have prescribed Topiramate AN for another reason.
Ask your doctor if you have any questions about why Topiramate AN has been prescribed for you. Topiramate AN is available only with a doctor’s prescription.
Before you take Topiramate AN
When you must not take it
- Do not take Topiramate AN if you are allergic to topiramate or any of the inactive ingredients listed at the end of this leaflet. Symptoms of an allergic reaction may include: wheezing, swelling of the lips/mouth, difficulty in breathing, hay fever, lumpy rash (hives) or fainting.
- Do not take Topiramate AN after the expiry date printed on the pack. If you take it after the expiry date has passed, it may not work as well.
- Do not take Topiramate AN if the tablets do not look quite right or if the packaging is torn or shows signs of tampering.
If you are not sure whether you should start taking Topiramate AN, talk to your doctor or pharmacist.
Before you start to take it
You must tell your doctor if you:
- have allergies to any medicine, foods, dyes or preservatives.
- are pregnant or intend to become pregnant. Topiramate has caused harm to the developing foetus when administered to a pregnant woman. Its safety has not been verified in pregnant women. Information available suggests there may be an association between the use of topiramate during pregnancy and birth defects. However, it is very important to control your fits while you are pregnant. If it is necessary for you to take Topiramate AN your doctor will discuss with you whether you should continue to take it during pregnancy.
- are breast-feeding or intend to breast-feed. Lactating women should be advised not to breast-feed during treatment with Topiramate AN. Your doctor will discuss the possible risks and benefits of taking/using Topiramate AN while breast-feeding.
- have or have had mental disorders such as depression or personality disorder.
- have or have had kidney stones, kidney disease or have a family history of kidney stones.
- have or have had liver problems.
- have or have had eye problem or high pressure in the eye.
If you have not told your doctor or pharmacist about any of the above, do so before you take Topiramate AN.
Taking other medicines
Tell your doctor or pharmacist if you are taking any other medicines, including medicines you buy without a prescription from your pharmacy, supermarket or health food shop.
In particular, tell your doctor or pharmacist if you are taking:
- other medicines for epilepsy (fits), such as phenytoin, carbamazepine or valproic acid
- digoxin (used to treat heart disease)
- oral contraceptives (the pill)
- metformin, pioglitazone, glibenclamide (used to treat sugar diabetes)
- acetazolamide used to treat glaucoma (increased intraocular pressure)
- lithium, risperidone (used to treat bipolar disorder and schizophrenia)
- haloperidol (used to treat psychoses)
- hydrochlorothiazide (used to treat swelling or high blood pressure)
- diltiazem or propranolol used to treat high blood pressure and or severe chest pain (angina)
- venlafaxine and amitriptyline (used to treat depression)
- flunarizine (used to treat migraine headache)
- any medicine which slows your reactions. This may include medicines to help you sleep or relieve pain, antidepressants, tranquillisers, alcohol or antihistamines which can make you drowsy
These medicines may be affected by Topiramate AN or may affect how well Topiramate AN works. Your doctor or pharmacist can tell you what to do if you are taking any of these medicines.
How to take Topiramate AN
Follow all directions given to you by your doctor or pharmacist carefully. This may differ from the information contained in this leaflet.
How to take it
You can take Topiramate AN with or without food. Always swallow the tablets whole with plenty of water.
When to take it
At the start of treatment Topiramate AN may be taken once a day, preferably at night. After the dose is increased, it is taken twice a day.
You should continue taking Topiramate AN until your doctor tells you to stop. Before stopping, it is recommended that the dose be reduced gradually.
How much and how long to take
The doses shown below are the usual recommended doses. However, your doctor may tell you to take higher or lower doses. Your doctor will start with a low dose and slowly increase the dose to the most suitable dose needed to control your epilepsy. Continue taking Topiramate AN for as long as your doctor tells you to. Do not stop taking Topiramate AN, or lower the dosage, without checking with your doctor.
If you are taking only Topiramate AN to treat your epilepsy:
For adults, treatment starts at a low dose of 25 mg/day as a single dose (nightly) for one week or longer. The dosage is then increased by 25 to 50 mg/day at weekly or longer intervals to the recommended target dose of 100 mg/day.
For children 2 years and over, treatment starts at a low dose of 0.5 to 1 mg/kg as a single dose (nightly) for the first week. The dosage is then increased by 0.5 to 1 mg/kg daily at weekly or longer intervals to the recommended target dose of 3 to 6 mg/kg/day.
If you are taking Topiramate AN with other antiepileptic drugs:
For adults, treatment starts at a low dose of 25 to 50 mg as a single dose (nightly) or divided dose for one week or longer. The dosage is then increased by 25 to 100 mg/day at weekly or longer intervals to the recommended target dose of 200 to 400 mg/day.
For children 2 years and over, treatment starts at 1 to 3 mg/kg/day up to 25 mg/day as a single dose (nightly) for the first week. The dosage is then increased by 1 to 3 mg/kg/day at weekly or longer intervals to the recommended target dose of 5 to 9 mg/kg/day.
Treatment starts at a low dose of 25 mg as a single dose (nightly) for one week. The dose is then increased over weekly periods or longer by 25 mg/day, until the most suitable dose is reached (only for adults).
If you forget to take it
- Take your dose as soon as you remember, and then go back to taking your medicine as you would normally.
- If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
- Do not take a double dose to make up for the dose you missed. This may increase the chance of you getting an unwanted side effect.
If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you have taken too much (overdose)
If you have taken too much, immediately telephone your doctor or the Poisons Information Centre (Tel. No. 13 11 26) for advice, or go to Accident & Emergency at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
Keep these numbers handy in case of an emergency.
If you take too much Topiramate AN, you may experience headache, lightheadedness, agitation, drowsiness, lethargy, convulsions, speech disturbances, double or blurred vision, difficulty with thinking, abnormal coordination, reduced responsiveness and awareness, hypotension, abdominal pain, dizziness and depression, muscular weakness, muscle cramps and change in heart rhythm (apart from that you may also experience other symptoms due to low levels of potassium in blood.
While you are using Topiramate AN
Things you must do
- Drink plenty of water while taking Topiramate AN. Topiramate AN has been known to cause kidney stones and drinking water may help to prevent this.
- Always follow your doctor's instructions carefully.
- If you are about to start taking a new medicine, tell your doctor or pharmacist that you are taking Topiramate AN.
- Tell your doctor if you become pregnant while taking Topiramate AN.
Things you must not do
- Do not suddenly stop taking Topiramate AN without checking with your doctor.
- Do not drink alcohol.
- Do not drive or operate machinery until you know how the medicine affects you.
- Do not use Topiramate AN to treat any other complaint unless your doctor says so.
- Do not give this medicine to anyone else to use.
Things to be careful of
Effects on thoughts and behaviour
Medicines used to treat epilepsy can increase the risk of suicidal thoughts and behaviour. If you experience feelings of deep sadness and unworthiness (depression) or a worsening of these feelings, any unusual changes in your mood, or the emergence of suicidal thoughts, behaviour or thoughts of self harm, you should report this to your doctor immediately.
Be careful driving or operating machinery until you know how Topiramate AN affects you. As with other anticonvulsant medicines, Topiramate AN may cause drowsiness, dizziness or other symptoms which could affect your ability to drive or operate machinery. It may also cause visual disturbances and/or blurred vision. Make sure you know how you are affected by this medicine before you drive or use machinery. If you drink alcohol, dizziness or light-headedness may be worse.
Particular care is recommended when you first start taking Topiramate AN or if the amount of Topiramate AN or any other medicine you are taking is increased or decreased.
Effects of food and alcohol
Topiramate AN can be taken with or without food. Do not drink alcohol while taking Topiramate AN. Alcohol may increase the risk of unwanted side effects, such as drowsiness.
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Topiramate AN. Topiramate AN helps most people with epilepsy/migraine, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects. Do not be alarmed by this list of possible side effects. You may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
- dizziness, unusual tiredness or drowsiness, weakness
- itchy skin or skin rash
- tingling and numbness in fingers and toes
- decrease in appetite or weight loss
- nausea (feeling sick), loose stool (diarrhoea), constipation
- changed sense of taste
- nose bleed
Tell your doctor as soon as possible if you notice any of the following as you may need medical attention:
- nervousness or anxiety
- abnormal behaviour
- difficulty with concentration or attention
- difficulty with memory and slowing of thought processes
- depression, mood problems, abnormal thoughts, thoughts of self- harm
- speech or language problems
- decreased or lack of sweating or overheating (mainly in children)
- reduced sense of touch or sensation
- reduced co-ordination
- balance disorder
- unusual hair loss or thinning
- abnormal frequent urination
- unusual weakness
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:
- thoughts of harming yourself or thoughts of suicide
- sudden signs of allergy such as rash, itching or hives, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or difficulty breathing
- sudden severe back or side pain, difficult or painful to pass urine
- blood in your urine or severe pain in the lower back or genital area
- sudden changes in your eyesight (eg. blurred, double vision or loss of vision) or uncontrollable eye movements
- eye pain or increased pressure in the eye
- severe blisters and bleeding in mucosal sites (such as lips, eyes, mouth, nose, genitals)
These are serious side effects. You may need urgent medical attention. Serious side effects are rare.
Other side effects not listed above may also occur in some people. Tell your doctor if you notice any other effects.
After using Topiramate AN
Keep Topiramate AN in the original pack until it is time to take it.
Keep Topiramate AN in a cool, dry place where the temperature is below 25 degrees C. Protect from light.
Do not store Topiramate AN or any medicine in the bathroom or near a sink. Do not leave medicines in the car or on window sills. Heat and dampness can destroy some medicines.
Keep Topiramate AN where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
If your doctor tells you to stop taking Topiramate AN, or your medicine has passed its expiry date, ask your pharmacist what to do with any tablets which may be left over.
What Topiramate AN looks like
- Topiramate AN 25 mg tablets are white, film-coated, circular tablets debossed with ‘TP1’ on one side and plain on the other side. Available in packs of 60 tablets.
- Topiramate AN 50 mg tablets are yellow, film-coated, circular tablets debossed with ‘TP2’ on one side and plain on the other side. Available in packs of 60 tablets.
- Topiramate AN 100 mg tablets are yellow, film-coated, circular tablets debossed with ‘TP3’ on one side and plain on the other side. Available in packs of 60 tablets.
- Topiramate AN 200 mg tablets are peach-coloured, film-coated, circular tablets debossed with ‘TP4’ on one side and plain on the other side. Available in packs of 60 tablets.
- Topiramate AN 25 mg tablets - 25 mg of topiramate
- Topiramate AN 50 mg tablets - 50 mg of topiramate
- Topiramate AN 100 mg tablets - 100 mg of topiramate
- Topiramate AN 200 mg tablets - 200 mg of topiramate
- Microcrystalline cellulose,
- pregelatinised maize starch,
- sodium starch glycolate (Type A),
- and magnesium stearate.
In addition the 25 mg tablet contains Opadry 12 B 58956 (White), the 50 mg and 100 mg tablets contain Opadry 12 B 52749 (Yellow), and the 200 mg tablet contains Opadry 12 B 56662 (Brown).
- Opadry 12 B 58956 (White) contains hypromellose 5 cp, titanium dioxide, macrogol PEG 400 and polysorbate 80.
- Opadry 12 B 52749 (Yellow) contains hypromellose 5 cp, titanium dioxide, macrogol PEG 400, polysorbate 80 and iron oxide yellow.
- Opadry 12 B 56662 (Brown) contains hypromellose 5 cp, titanium dioxide, macrogol PEG 400, polysorbate 80 and iron oxide red.
Topiramate AN is supplied in Australia by:
Amneal Pharma Australia Pty Ltd
12 River St
Australian Registration Numbers
- Topiramate AN 25 mg tablets:
AUST R 157962
- Topiramate AN 50 mg tablets:
AUST R 157960
- Topiramate AN 100 mg tablets:
AUST R 157974
- Topiramate AN 200 mg tablets:
AUST R 157961
This leaflet was prepared in February 2015.
Published by MIMS September 2015