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Compare Topamax vs. Zonegran

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

Key takeaways

Topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) and zonisamide (Zonegran) are both antiepileptic medications, but they have some key differences. Topiramate can be used alone or with other medications to treat various types of seizures and to prevent migraines, while zonisamide is only used with other medications to control partial-onset seizures. Topiramate is available in multiple forms, including immediate-release and extended-release tablets, capsules, and a liquid solution, whereas zonisamide comes as capsules and an oral suspension. Topiramate can be used in children as young as 2 years old for seizures, but zonisamide is only approved for people aged 16 and older. Both medications can cause higher acid levels in the blood, have risks associated with pregnancy, and can lead to serious eye problems. However, topiramate is known to interact with more medications compared to zonisamide. Both medications are available as a lower-cost generic.

Topiramate
Zonisamide (Zonegran)
Topiramate
Zonisamide (Zonegran)
Summary of Topamax vs. Zonegran
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Summary for Antiepileptic
Prescription only
Zonisamide (Zonegran) is used along with other medications to help control partial-onset seizures in people with epilepsy. It comes as an oral capsule that's available as a lower-cost generic. An oral suspension form of the medication is also available, but it's brand only and can be expensive.
Indications of Topamax vs. Zonegran
Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention

Indications for

•Partial-onset seizures
Pros and Cons of Topamax vs. Zonegran
Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow

Pros and Const for Antiepileptic
Pros

•Capsules available as a lower-cost generic

•Can take once a day, so it's easier to remember to take

•Can take with or without food

•Can be a good add-on treatment to control seizures when other medications aren't working well enough

•Comes as an oral suspension, which is an option for those who have problems swallowing

Cons

•Can't be used by itself to control seizures

•Only approved for people ages 16 years and older

•Can take several weeks to get the full benefits of the medication

•Not safe to take if you have a sulfa allergy

•Might not be safe to take during pregnancy
Common Side Effects of Topamax vs. Zonegran
Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance

Common Side Effects for

•Sleepiness (17%)

•Dizziness (13%)

•Loss of appetite (13%)

•Headache (10%)

•Nausea (9%)

•Agitation or irritability (9%)

•Fatigue (8%)

•Tiredness (7%)

•Depression (6%)

•Problems with concentration or memory (6%)

•Stomach pain (6%)

•Double vision (seeing double; 6%)
Warnings of Topamax vs. Zonegran
Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications

Common Side Effects for

•Sulfa medication allergy

•Serious skin reactions

•Serious allergic reactions involving organs

•Reduced sweating and risk of heat stroke

•Serious eye problems

•Suicidal behavior

•Problems with mood or thinking

•Kidney problems

•Higher blood acid

•Withdrawal seizures

•Harm to unborn baby
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Compare Topamax vs. Zonegran

Key takeaways

Summary of Topamax vs. Zonegran

Indications of Topamax vs. Zonegran

Pros and Cons of Topamax vs. Zonegran

Common Side Effects of Topamax vs. Zonegran

Warnings of Topamax vs. Zonegran

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