11 Topiramate Side Effects You Should Know About
Topiramate (Topamax) is a seizure and migraine medication that may cause “pins and needles," weight loss, and confusion. See more topiramate side effects here.
topiramate ER (Qudexy XR)
Used for Epilepsy, Lennox-Gastaut Syndrome
Used for Epilepsy, Lennox-Gastaut Syndrome
Topiramate extended-release capsule (Qudexy XR) is an antiepileptic medication. It can be taken by itself or with other medications to treat certain types of seizures in people 2 years and older. It can also help prevent migraines in people 12 years and older. The dosage is taken once a day. You can swallow the capsule whole or open it and sprinkle onto soft food. Some side effects including tingling of the arms and legs and weight loss. This medication also has drug interactions to look out for.
What is Topiramate (Qudexy XR)?
What is Topiramate (Qudexy XR) used 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
How Topiramate (Qudexy XR) works
Topiramate (Qudexy XR) is an antiepileptic medication. It's not exactly clear how it works. But researchers think it blocks certain signals or chemicals in the brain that can make it too active. This helps calm the brain to control seizures and prevent migraines.
When does Topiramate (Qudexy XR) start working?Time passed since treatment started:
Drug facts
| Common Brands | Qudexy XR |
|---|---|
| Drug Class | Antiepileptic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Topiramate (Qudexy XR) essentials
Side effects of Topiramate (Qudexy XR)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Drowsiness (12%)
- Dizziness (7%)
- Tingling in arms and legs (7%)
- Weight loss (7%)
- Feeling tired (6%)
- Low appetite (4%)
Less Common Side Effects
- Weakness
- Irritability
- Trouble speaking clearly
- Problems with memory
- Bleeding (e.g., nosebleeds, bruising)
- High blood pressure
Note: Side effects listed were from people taking topiramate (Qudexy XR) with other anti-seizure medications for partial-onset seizures.
Topiramate (Qudexy XR) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Vision problems: sudden blurry vision, sudden eye redness, sudden eye pain, other changes in vision
- Very high body temperature, leading to heat exhaustion or heatstroke: fever, headache, tiredness, dizziness, confusion, nausea, vomiting, muscle cramps, skin that's very warm or hot to the touch
- Very high acid levels (metabolic acidosis): feeling very tired, breathing very fast, poor appetite, irregular heartbeat
- Very high ammonia levels: very tired, confused, trouble focusing, vomiting
- Kidney stone: intense pain in your mid to lower back, side, or lower stomach; dark, cloudy, or bloody urine; feeling the urge to urinate
- Serious skin reaction: rash, skin pain, blisters, skin peeling, fever, sore throat
- Serious bleeding: bleeding that's hard to stop, more menstrual bleeding than usual, bloody vomit, blood in the urine or stool, tarry stool
- Suicidal thoughts or behaviors
When do Topiramate (Qudexy XR) possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Drowsiness
Feeling tired
Tingling in arms and legs
Low appetite
Weight loss
Risk of suicidal thoughts
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
More on Topiramate (Qudexy XR) side effects
The following Topiramate (Qudexy XR) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Fever that does not go away, fast breathing or heartbeat, fatigue
- High acid level—trouble breathing, unusual weakness or fatigue, confusion, headache, fast or irregular heartbeat, nausea, vomiting
- High ammonia level—unusual weakness or fatigue, confusion, loss of appetite, nausea, vomiting, seizures
- Kidney stones—blood in the urine, pain or trouble passing urine, pain in the lower back or sides
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Burning or tingling sensation in hands or feet
- Difficulty with paying attention, memory, or speech
- Dizziness
- Drowsiness
- Fatigue
- Loss of appetite with weight loss
- Slow or sluggish movements of the body
Get your GoodRx coupon
$249.14
GoodRx discount
$75.92
Pros and cons of Topiramate (Qudexy XR)
Pros
- Taken once a day
- Can take on its own or with other medications to control seizures
- An option for preventing migraines
- Can open capsules and sprinkle onto soft food, so it's convenient for people who have trouble swallowing pills
Cons
- Can cause drowsiness and tingling of the arms or legs
- Might raise the risk of bleeding (e.g., nosebleeds, bruising)
- Interacts with many medications, like birth control pills, warfarin, and divalproex (Depakote)
Pharmacist tips for Topiramate (Qudexy XR)
- Take topiramate (Qudexy XR) once a day, with or without food.
- You can swallow the topiramate (Qudexy XR) capsule whole. Don't crush or chew the capsule.
- You can also open the topiramate (Qudexy XR) capsule and sprinkle the medication onto a spoonful of soft food like applesauce. Swallow the mixture right away without chewing. Don't store it for a later time.
- Topiramate (Qudexy XR) can make you feel drowsy or dizzy. It can also make it hard to focus. Don't drive or do anything that you need to concentrate for until you know how the medication affects you.
- It's best to avoid drinking alcohol while taking topiramate (Qudexy XR). It can make you feel more drowsy or dizzy. If it's hard for you to cut down on alcohol, talk to your care team for help.
- Be sure to drink plenty of fluids while taking topiramate (Qudexy XR). This medication can sometimes cause kidney stones. But staying hydrated can help prevent them.
- Topiramate (Qudexy XR) might make you sweat less and lead to overheating. When it’s hot, try to stay cool and drink lots of water. Get medical help right away if you have a fever, hot skin, headache, muscle cramps, dizziness, or confusion. These could be signs of heat exhaustion or heatstroke.
- Topiramate (Qudexy XR) might raise your risk of bleeding and make nosebleeds or bruising more likely. Get medical help right away if bleeding won’t stop or if you see blood in your urine or stool. This could be serious.
- Talk to your care team about any vision changes while taking topiramate (Qudexy XR). Watch for sudden blurry vision, eye pain, or vision loss. This medication can sometimes cause vision problems that should get checked right away.
- Talk to your prescriber first before stopping topiramate (Qudexy XR). Don't stop suddenly since it can raise your risk of seizures. Your prescriber can help you stop safely by slowly lowering your dose over a few weeks.
- Tell your prescriber and pharmacist about all the medications you take or plan to take. Topiramate (Qudexy XR) can interact with many medications. These can include ibuprofen (Advil), blood thinners like warfarin, and birth control pills. Your care team can check for interactions and make changes if needed to keep you safe.
- Let your prescriber know right away if you get pregnant while taking topiramate (Qudexy XR). This medication can harm your baby. Your prescriber can help you understand the risks and benefits. They can help you find a safer medication for you and your baby.
More on Topiramate (Qudexy XR) tips
Risks and warnings for Topiramate (Qudexy XR)
Topiramate (Qudexy XR) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Vision problems
Some people taking topiramate (Qudexy XR) have had eye problems. They can be related to nearsightedness and greater pressure in the eye(s). Symptoms can include eye redness, blurry vision, and eye pain. These symptoms usually happen within the first month of treatment, but they can also happen later. Symptoms can come on suddenly.
Tell your care team or eye specialist right away if you notice any changes in your vision while taking topiramate (Qudexy XR). They can check what's going on because eye problems can become serious if left untreated. If needed, your prescriber can stop the medication to keep your vision from getting worse. To do this safely, they'll help lower your dose slowly over time. Usually, these vision problems will go away after you stop taking it.
High body temperature and trouble sweating
- Risk factor: Children | Hot weather | Taking anticholinergic medications | Taking other medications that make you sweat less
Some people might sweat less while taking topiramate (Qudexy XR). This can make it harder to control your body temperature. It can lead to overheating and high body temperature, which is dangerous. The risk might be higher for children. The risk is also higher if you take other medications that make you sweat less, such as anticholinergic medications.
Pay attention to how much you sweat or how hot you feel while you're exercising or in hot weather. Stay hydrated, use mist fans, and take breaks in the shade on hot days. If you can, try to stay indoors where there's air conditioning when the weather is hot. Call 911 if you or your child has signs of heat stroke or heat exhaustion, like dizziness, hot skin, headache, muscle cramps, or confusion.
Too much acid in the blood (metabolic acidosis)
- Risk factors: Kidney problems | Severe breathing problems | Diarrhea | Keto diet | Serious seizure condition called status epilepticus
Although rare, topiramate (Qudexy XR) can raise the acid levels in your blood. This condition is called metabolic acidosis. It can happen at any time during treatment. If left untreated, high acid levels can raise your risk of kidney stones and bone fractures. In children, this condition can lead to poor bone growth.
To monitor this risk, your prescriber will ask you to do a blood test before you start topiramate (Qudexy XR). You'll also need periodic blood tests during treatment. This helps make sure the acid levels in your blood aren't too high.
Call your care team right away if you have signs of metabolic acidosis while taking topiramate (Qudexy XR). Signs can include fast breathing, tiredness, loss of appetite, or irregular heartbeat. If your acid levels are too high, your prescriber might lower your dose or stop the medication. If needed, they can give you treatment for metabolic acidosis.
Changes in mood and risk of suicidal thoughts or behavior
- Risk factors: History of depression | Taking other seizure medications or medications that affect mood
Topiramate (Qudexy XR) can cause changes in mood. It can also raise the risk of suicidal thoughts or behavior. The risk can appear as early as 1 week after starting the medication.
Make sure your friends and family know to watch for signs of depression or changes in your mood or behavior while you're taking topiramate (Qudexy XR). This is especially important during the first few months and when your dose goes up. If you start thinking about hurting yourself, call 911 right away.
Problems with memory, speech, or coordination
- Risk factors: Starting topiramate (Qudexy XR) at a higher dose | Raising the dose too fast
Topiramate (Qudexy XR) can make it harder for you to remember things. It can also cause problems with speech and coordination. Tell your care team if you notice you're forgetting things more often, having problems with speech, or having a hard time moving around. They can check what's going on and see how they can help you.
Sleepiness, tiredness, and lower concentration
- Risk factors: Starting topiramate (Qudexy XR) at a higher dose | Raising the dose too fast
Topiramate (Qudexy XR) can make you sleepy or tired. It can also make it harder for you to concentrate. To be safe, don't drive or use machinery until you know how this medication affects you. Also don't drink alcohol with topiramate (Qudexy XR) because it make these side effects worse.
High ammonia levels in the blood
- Risk factors: History of metabolic disorders | Taking divalproex (Depakote) or valproic acid | Higher dose of topiramate (Qudexy XR)
Topiramate (Qudexy XR) can cause ammonia to build up in your body. The risk is higher if you take it with valproic acid or divalproex (Depakote). Some people might not have symptoms, but others can.
Signs of high ammonia levels include feeling more tired or confused, having trouble concentrating, or vomiting. In serious cases, high ammonia levels can affect the brain. Get medical help right away if you notice any of these symptoms.
Serious skin reactions
Topiramate (Qudexy XR) has a risk of causing serious skin reactions. This includes Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). If you have a rash, blisters, skin peeling, other unusual changes in your skin, or high fever, get medical help right away. Your care team will help lower your dose slowly over time to stop the medication. They'll talk to you about safer options to treat your condition.
Kidney stones
- Risk factors: Men | Keto diet | Taking medications called carbonic anhydrase inhibitors
Topiramate (Qudexy XR) can raise your risk of kidney stones. The risk might be higher if you follow a ketogenic (keto) diet. You can also be at risk if you take medications called carbonic anhydrase inhibitors, like acetazolamide. Be sure to drink plenty of fluids to help prevent kidney stones.
Risk of seizures if you stop the medication suddenly
Talk to your prescriber before stopping topiramate (Qudexy XR). Stopping suddenly can raise your risk of seizures. If you take it to control seizures, stopping too quickly can make them come back or happen more often. Your prescriber can help you slowly lower your dose to stop safely.
Bone or growth problems in children
In studies, some children taking immediate-release topiramate had signs of having weaker bones. It's unclear if this directly raises the risk of fractures. Get medical help right away if your child breaks a bone while taking topiramate (Qudexy XR). Let their prescriber know afterwards.
Studies also suggest that topiramate (Qudexy XR) might slow growth in children (in height and weight). The care team will keep track of your child's growth during follow-up visits. Talk to your prescriber if you're worried about your child's growth progress.
Interaction with other medications
Topiramate (Qudexy XR) can interact with many medications. Some interactions can make medications work less well. Others can put you at risk of side effects. It's important to tell your care team about all the medications you take and plan to take. They can check for interactions and make adjustments to your medications to keep you safe, if needed.
In particular, topiramate (Qudexy XR) can interact with medications called carbonic anhydrase inhibitors. These include acetazolamide and zonisamide (Zonegran). This can raise the risk of metabolic acidosis and kidney stones.
Another example is taking topiramate (Qudexy XR) with valproic acid or divalproex (Depakote). This interaction can make your body temperature drop. This can lead to symptoms like shivering, tiredness, trouble moving at your typical speed, confusion, or more seriously, coma. If this happens, get medical help right away.
Harm to an unborn baby
Topiramate (Qudexy XR) can harm an unborn baby if taken during pregnancy. It's caused birth defects like cleft lip or cleft palate. Some newborns might also be smaller than expected.
Tell your prescriber if you're pregnant or planning to become pregnant. They can explain the risks and benefits of taking topiramate (Qudexy XR) during pregnancy. If you're not planning a pregnancy, it's recommended that you use birth control while taking this medication to lower your risk.
If you take topiramate (Qudexy XR) while pregnant, you can join the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This program helps researchers learn more about how safe the medication is for you and your baby.
Topiramate (Qudexy XR) dosage
The average cost for 30 capsules of 25mg of Topiramate (Qudexy XR) is $75.92 with a free GoodRx coupon. This is 69.53% off the average retail price of $249.14. 
Capsule
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 capsules | $75.92 | $2.53 |
| 50mg | 30 capsules | $75.92 | $2.53 |
| 100mg | 30 capsules | $129.00 | $4.30 |
| 150mg | 30 capsules | $160.21 | $5.34 |
| 200mg | 30 capsules | $160.21 | $5.34 |
Typical dosage for Topiramate (Qudexy XR)
In general, your dose is slowly raised over a few weeks. The dose depends on why you're taking it and what other medications you take. The dose might be lower if you have kidney problems.
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Seizures (when taken by itself)
- Adults and children 10 years or older
- Week 1: The typical dose is 50 mg by mouth once a day.
- Week 2: The typical dose is 100 mg by mouth once a day.
- Week 3: The typical dose is 150 mg by mouth once a day.
- Week 4: The typical dose is 200 mg by mouth once a day.
- Week 5: The typical dose is 300 mg by mouth once a day.
- Week 6 and beyond: The typical dose is 400 mg by mouth once a day.
- Children 2 to 9 years old: The typical starting dose is 25 mg by mouth at night for the first week. The dose is raised each week up to a maintenance dose. Depending on your child's weight, the maintenance dose ranges from 150 mg to 400 mg by mouth once a day.
- Adults and children 10 years or older
-
Seizures (when taken with other anti-seizure medications)
- Adults 17 years or older: The typical starting dose is 25 mg to 50 mg by mouth once a day. The dose is slowly raised every week up to a maintenance dose. The typical maintenance dose is between 200 mg and 400 mg once a day.
- Children 2 to 16 years old: The dose is based on your child's weight. The typical starting dose is 1 mg/kg to 3 mg/kg (up to 25 mg) by mouth every night for the first week. The dose is slowly raised over a few weeks to a maintenance dose. The typical maintenance dose can range from 5 mg/kg to 9 mg/kg once a day. The maximum daily dose is 400 mg.
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Migraine prevention
- Adults and children 12 years or older
- Week 1: The typical dose is 25 mg by mouth once a day.
- Week 2: The typical dose is 50 mg by mouth once a day.
- Week 3: The typical dose is 75 mg by mouth once a day.
- Week 4 and beyond: The typical dose is 100 mg by mouth once a day.
- Adults and children 12 years or older
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How much does Topiramate (Qudexy XR) cost?
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What are alternatives to Topiramate (Qudexy XR)?
There are a number of medications that your doctor can prescribe in place of Topiramate (Qudexy XR). Compare a few possible alternatives below.
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Topiramate (Qudexy XR) images
