Topiramate for preventing seizures

This leaflet is about This leaflet is about the use of topiramate to prevent epileptic seizures. (Seizures may be also called convulsions or fits.)

Do not stop giving topiramate suddenly, as your child may have more seizures.

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Topiramate

Brand name: Topamax^®

Why is it important for my child to take this medicine?

It is important that your child takes topiramate regularly so that they have fewer seizures.

What is topiramate available as?

tablets: 25 mg (white), 50 mg (light-yellow), 100 mg (yellow), 200 mg (salmon pink)
‘sprinkle capsules’ (15 mg, 25 mg, 50 mg)

When should I give topiramate?

You will usually start by giving topiramate once a day, while your child gets used to the medicine. This is usually in the evening.

When your child is used to topiramate, you will usually give it twice a day: once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example sometime between 7 and 8 am and between 7 and 8 pm.

How much should I give?

Your doctor will work out the amount of topiramate (the dose) that is right for your child. The dose will be shown on the medicine label.

When you first start giving topiramate to your child, you will give them a small amount and then increase the dose bit by bit over a few days or weeks. This helps your child to get used to the medicine. Your doctor will explain what to do.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Topiramate should not be given with food, as it will not work properly. Your child can have food half an hour after taking the medicine.

	Tablets should be swallowed with a glass of water, juice or milk. Your child should not chew the tablets.
	You can crush a tablet and mix it with about 2 tablespoons of fruit juice or soft food (e.g. yogurt, honey or jam). Make sure your child swallows it straight away, without chewing.
	‘Sprinkle capsules’: Open the capsule and sprinkle the granules into a teaspoonful of soft food (e.g. yogurt, honey or jam). Make sure your child swallows it all straight away, without chewing.These capsules can also be swallowed whole with a glass of water, juice or milk.

When should the medicine start working?

It may take a few weeks for topiramate to work properly, so your child may still have seizures for a while. Continue to give the medicine in the way that you have been told to by your doctor.

What if my child is sick (vomits)?
If your child is sick less than 30 minutes after taking a dose of topiramate, give the same dose again.
If your child is sick more than 30 minutes after taking a dose of topiramate, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

If you remember within 4 hours, give your child the missed dose. For example, if you usually give a dose at 7 am, you can give the missed dose at any time up to 11 am. If you remember after this time, do not give the missed dose. Wait until it is time to give the next normal dose.

Never give a ‘double dose’ of topiramate.

What if I give too much?

If you think you may have given your child too much topiramate, contact your doctor or NHS Direct (0845 4647), or take your child to hospital.

Take the medicine container or pack with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects you must do something about

Children may sweat less when taking topiramate. Be careful that they don’t overheat, particularly in hot weather.

Other side-effects you need to know about

The most common side-effects with topiramate are poor appetite, drowsiness (sleepiness) and headache. These effects should get better within about a month. If they don’t, contact your doctor for advice.
Your child may lose weight, get tummy upsets or ‘pins and needles’, feel dizzy, have blurred vision or may be unsteady. Your child’s behaviour may change, and they may become moody or seem nervous. Their sleep may be disturbed.
Your child may have some difficulty concentrating. Rarely, they may also have some difficulty in finding the right words when talking. If either of these problems persists, contact your doctor for advice.
Kidney stones are more common when taking topiramate. You can help to prevent this by making sure that your child drinks plenty of fluids. If your child gets severe pain in their back or groin, has pain when passing urine (doing a wee), or there is blood in the urine (wee), take them to your doctor straight away.

Can other common medicines be given at the same time as topiramate?

You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

If your child is going to have treatment in hospital, it is important to tell the doctor that your child is taking topiramate.

Epilepsy and pregnancy

Pregnancy presents a risk to both the mother with epilepsy and her unborn baby. If your daughter has sex, it is essential that she uses adequate contraception to prevent an unplanned pregnancy.
If your daughter is worried that she may be pregnant, it is important that she sees your family doctor as early as possible. Your daughter should keep taking her medication until she sees her doctor.

Topiramate and pregnancy

Topiramate is not thought to harm an unborn baby.
The oral contraceptive pill may not work properly in women or girls who are taking topiramate.

General advice about medicines for epilepsy

Do not suddenly stop giving any of these medicines to your child, as they may have a seizure. If you are worried, talk to your doctor but carry on giving the medicine to your child as usual.
If your child seems to have more seizures than usual, contact your doctor or epilepsy nurse.
If your doctor decides to stop a particular medicine, they will discuss this with you. You will usually reduce the dose bit by bit.
Do not reduce the dose without talking to your doctor first.
It is best that your child always has the same brand of each medicine, as there may be differences between brands. Keep a record of which medicines your child has.
Try to give medicines at about the same times every day, to help you remember.
Only give the medicine(s) to your child. Never give them to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
Make sure that children cannot see or reach the medicine.
Keep the medicine in the container it came in.