Topiramate for preventing seizures

Name of medicine

Topiramate

Brand name: Topomax

Why is it important for my child to take Topiramate?

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

What is Topiramate available as?

• Tablets: 25 mg, 50 mg, 100 mg, 200 mg
• Capsules: 15 mg, 25 mg, 50 mg (sprinkle capsules)

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 probably give them a low dose, which may be increased 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.

How should I give Topiramate?

Tablets

• Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablets.
• You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey, or mashed potato. Make sure your child swallows it straight away, without chewing.

Sprinkle capsule

• 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 squash.

When should the medicine start working?

It may take a few weeks for Topiramate to work properly, so your child may still have their symptoms for a while. Continue to give the medicine as 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 having a dose of Topiramate, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of Topiramate, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

• If you remember up to 4 hours after you should have given a dose, 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 that time, do not give the missed dose. Wait until it is time to give the next normal dose.

What if I give too much?

If you think you may have given your child too much Topiramate, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

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

Side effects you must do something about

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, take them to your doctor straight away.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other 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 and complementary medicines.

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 may harm an unborn baby. This should be discussed with your doctor.
• The oral contraceptive pill can be used safely by women or girls who are taking topiramate. However, she may need to take a higher-strength pill to ensure adequate contraception. This should be discussed with her GP or family planning clinic.

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

• If your child is going to have treatment in hospital, it is important that you tell the doctor that your child is taking Topiramate

General advice about medicines

• If your child seems to have more seizures than usual, contact your doctor or your epilepsy nurse.

Advice about medicines for seizures

• If your doctor decides to stop a particular medicine, they will discuss this with you. They will usually reduce the dose bit by bit.
• 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 each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• 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 medicines you have at home have 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.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Topiramate and about other medicines used to treat epilepsy.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by January 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.