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Compare Topamax vs. Cafergot

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) and ergotamine/caffeine (Cafergot, Migergot) are both medications used to treat migraines, but they belong to different medication classes. Topiramate is an antiepileptic medication that can also prevent migraines, while ergotamine/caffeine is an ergot derivative and PDE inhibitor used to treat active migraine and cluster headache episodes. Topiramate is available in various forms, including tablets, capsules, and a liquid solution, and is typically taken once or twice daily. In contrast, ergotamine/caffeine is available as oral tablets and rectal suppositories, taken as needed at the onset of a headache. Topiramate comes in both branded and generic forms, while ergotamine/caffeine only comes as a generic. Common side effects of topiramate include drowsiness, weight loss, and nervousness, whereas ergotamine/caffeine commonly causes nausea. Topiramate has many drug interactions, while ergotamine/caffeine should not be taken with certain antibiotics or protease inhibitors.

Topiramate (Topamax)
Cafergot (ergotamine / caffeine)
Topiramate (Topamax)
Cafergot (ergotamine / caffeine)
Summary of Topamax vs. Cafergot
Summary for Antiepileptic
Prescription only
Topiramate (Topamax) belongs to the drug class called antiepileptics. It can be used alone or together with other medications to treat certain types of seizures in people 2 years and older. Topiramate (Topamax) can also be used to prevent migraines in people 12 years and older. It comes as immediate-release tablets and sprinkle capsules. The dosage is taken by mouth twice daily. Topiramate (Topamax) has many possible side effects, like weight loss and tingling of the arms and legs. It can also interact with many other medications.
Summary for Ergot derivative / PDE inhibitor, nonselective
Prescription only
Cafergot (ergotamine / caffeine) is used to treat cluster headaches and migraines in adults. It's available as a tablet that's taken by mouth, as well as a suppository that's inserted into the rectum. Typically, you take a dose as soon as you feel a headache coming on. But there's a limit to how many doses you can take each week because taking this medication too often can lead to serious side effects, such as vomiting and numbness. Brand name Cafergot is discontinued.
Indications of Topamax vs. Cafergot
Indications for

•Seizures (partial-onset, tonic-clonic, or those from Lennox-Gastaut syndrome) in people 2 years and older

•Migraine prevention in people 12 years and older

Indications for

•Headache pain caused by swollen or widened blood vessels (vascular headaches)
Pros and Cons of Topamax vs. Cafergot
Pros and Const for Antiepileptic
Pros

•Can take by itself or with other medications to control seizures

•An option for preventing migraines

•Also available as a sprinkle capsule that you can open and mix contents with soft food (for people who have trouble swallowing pills)

•Approved for both adults and children (age depends on the health problem)

Cons

•Taken twice a day

•Can cause sleepiness and tingling in the arms or legs

•Risk of some serious side effects, like eye problems and kidney stones

•Interacts with many medications, like birth control pills, warfarin, and divalproex (Depakote)

Pros and Const for Ergot derivative / PDE inhibitor, nonselective
Pros

•Suppository is a good option for people who've trouble swallowing pills

•Tablet is available as a lower-cost generic

•Can start to feel relief after a half hour (for the tablets) or an hour (for the suppository); and you may take an additional dose if no relief

Cons

•Not for daily or long-term use

•Can't take while pregnant

•Not safe for use for people with kidney or liver problems

•Rectal suppository is brand name only and requires refrigeration
Common Side Effects of Topamax vs. Cafergot
Common Side Effects for

•"Pins and needles" feeling

•Sleepiness

•Dizziness

•Fatigue

•Low appetite

•Weight loss

•Nervousness

•Depression

•Trouble concentrating

•Trouble remembering things

•Trouble sleeping

•Trouble moving or keeping balance

•Fever

•Mood changes

•Change in taste

Common Side Effects for

•Nausea
Warnings of Topamax vs. Cafergot
Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Too much acid in the blood (metabolic acidosis)

•Changes in mood and risk of suicidal thoughts or behavior

•Problems with memory, speech, or coordination

•Sleepiness, tiredness, and lower concentration

•High ammonia levels in the blood

•Serious skin reactions

•Kidney stones

•Risk of seizures if you stop the medication suddenly

•Bone or growth problems in children

•Interaction with other medications

•Harm to an unborn baby

Common Side Effects for

•Dangerously low blood flow to your brain and limbs

•Fibrosis (scarring)

•Allergic reaction to yellow dye
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Compare Topamax vs. Cafergot

Key takeaways

Summary of Topamax vs. Cafergot

Indications of Topamax vs. Cafergot

Pros and Cons of Topamax vs. Cafergot

Common Side Effects of Topamax vs. Cafergot

Warnings of Topamax vs. Cafergot

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