Although topiramate is FDA-approved for treating seizures and preventing migraines, it is also commonly used by leading specialist obesity clinicians and weight clinics off-label to help aid with weight loss by reducing appetite and cravings.
Topiramate typically comes in a tablet form and extended release capsules (25 mg, 50 mg, 100 mg and 200 mg) and sprinkle capsules (15 mg and 25 mg) and extended release sprinkle capsules (25 mg, 50 mg, 100 mg, 150 mg, 200 mg) and liquid form (25 mg/ml). Dosing instructions vary according to weight, tolerability and other factors and should be discussed with your healthcare provider.
Topiramate is only FDA-approved to treat seizures and prevent migraines. Prescribing medications are up to a medical provider’s discretion and may not be appropriate for everyone.
Before using topiramate, tell your healthcare provider about your medical history, especially if you have:
Topiramate may cause some people to sweat less. It is recommended to avoid alcohol and stay well hydrated while taking this medication.This drug may make you dizzy or drowsy or impair your judgment. Please do not drive, operate heavy machinery, or perform any hazardous task until the effects of topiramate are known to you. For anyone taking diabetes medications, please have a discussion with your prescribing clinician prior to taking topiramate as your diabetes medications may need to be adjusted as you lose weight.
Topiramate may also cause birth defects (particularly there is a risk of cleft lip and/or palate and low birth weight). Topiramate may cause breakthrough bleeding. DO NOT take topiramate if you are planning to become pregnant or if pregnant or breastfeeding.
Many people experience no side effects while taking topiramate. Some of the most common side effects (but not extremely frequent) are:
Additional side effects include:
These symptoms may subside after the body adjusts to the medication.
As with other medications, topiramate can interact with alcohol, marijuana and certain medications, including antiepileptic drugs, CNS depressants, oral contraceptives, lithium, other carbonic anhydrase inhibitors, hydrochlorothiazide, pioglitazone and amitriptyline. Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information.
To report suspected adverse reactions to topiramate contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
In case of emergencies, please call 911 or go to the nearest emergency room.
