Topiramate to prevent migraine
Topamax
Revisado por pares por Sid DajaniÚltima actualización por Michael Stewart, MRPharmSLast updated 25 Jun 2024
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Clinical author's note: Michael Stewart 25/06/2024: the Medicines and Healthcare products Regulatory Agency (MHRA) has introduced new pregnancy safety measures for women and girls needing treatment with topiramate (Topamax®).
Due to an increased risk of birth defects you should not become pregnant whilst taking topiramate. A pregnancy test will be required before your doctor will start treatment with this medicine. Women and girls of childbearing potential must use effective contraception during treatment with topiramate. Some types of hormonal contraception are less effective when taking this medicine. Make sure you have discussed with your doctor which types of contraception are suitable.
If you are already taking topiramate for epilepsy and think you may be pregnant, do not stop taking your medication. Epileptic seizures can also harm an unborn baby. Make an appointment to see your doctor as soon as possible.
Speak with your doctor if you are planning to become pregnant or think you may be pregnant whilst taking this medicine.
Take topiramate every day.
If you become depressed or develop any problems with your eyesight, make an appointment to see your doctor straightaway.
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About topiramate
Tipo de medicamento | Un medicamento antiepiléptico |
Usado para | Prevention of migraine in adults |
También llamado | Topamax® |
Disponible como | Tablets and Sprinkle® capsules, oral liquid medicine |
In people with migraña, it is thought that some chemicals in the brain increase in activity and, as a result, parts of the brain then send out confused signals which result in the symptoms of headache and sickness. Why people with migraine should develop these chemical changes is not clear and many migraine attacks occur for no apparent reason. For some people, however, there may be things which trigger an attack, like certain foods or drinks.
Topiramate is classed as an antiepileptic medicine. It is usually used to prevent seizures in people with epilepsy and there is another leaflet called Topiramate for epilepsy which gives more information about this. However, topiramate has also been found to prevent migraine attacks from occurring. When used for migraine, it may not completely stop every migraine attack, but the number and severity of attacks are often reduced.
Before taking topiramate
Volver al contenidoSome medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking topiramate it is important that your doctor knows:
Si estás embarazada, intentando tener un bebé o amamantando.
Si tienes algún problema con el funcionamiento de tu hígado, o con el funcionamiento de tus riñones.
Si tienes un trastorno sanguíneo hereditario raro llamado porfiria.
Si está tomando otros medicamentos. Esto incluye cualquier medicamento que esté tomando y que esté disponible para comprar sin receta, así como medicamentos herbales y complementarios.
Si alguna vez has tenido una reacción alérgica a un medicamento.
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How to take topiramate
Volver al contenidoBefore you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about topiramate and will provide you with a full list of the side-effects which you may experience from taking it.
Take topiramate exactly as your doctor tells you to. It is usual to start topiramate treatment on a low dose (25 mg at night), and then for the dose to be increased gradually. A usual maintenance dose is 50-100 mg daily, taken either as a single dose or divided into two doses over the day.
Swallow topiramate tablets with a drink of water. Do not chew the tablets as they have a bitter taste. If you have been prescribed capsules, you can swallow the capsules in the normal way with a drink of water or, if you prefer, you can open up the capsule and sprinkle the contents on to a spoonful of some soft food (porridge, yoghurt or custard for example). Do not chew the contents of the capsules.
It is important that you drink plenty of water while you are taking topiramate. This is because there is a slight risk that kidney stones can develop and drinking plenty of water reduces this risk.
Try to get into a habit of taking topiramate at the same time(s) each day. You can take topiramate before or after food.
Si olvida tomar una dosis, tómela tan pronto como lo recuerde, a menos que esté cerca la hora de su próxima dosis, en cuyo caso omita la dosis olvidada. No tome dos dosis juntas para compensar una dosis olvidada.
Obteniendo el máximo de tu tratamiento
Volver al contenidoTry to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You may need to have eye tests and weight checks from time to time.
You need to take topiramate every day. Stopping suddenly can cause problems and your doctor may want you to reduce your dose over a few days if this becomes necessary.
This medicine is used to help prevent migraines, although it is unlikely to stop your migraine attacks completely. If a migraine attack occurs, you can take painkillers or a triptan to treat the pain during an attack.
A number of things can trigger migraine in some people. These can include some foods (for example, cheese, chocolate, and red wine), worry, bright sunlight, too much or too little sleep, and skipping meals. If you are not sure if these things trigger a migraine for you, it may help for you to keep a migraine diary. Note down when and where each migraine attack started, what you were doing, and what you had eaten that day. A pattern may emerge and it may be possible for you to avoid some of the things that trigger an attack.
Some people who get frequent migraine attacks are in fact getting medication-induced headache. Medication-induced headache (also called medication-overuse headache) is caused by taking painkillers too often. If you use painkillers on more than two days a week on a regular basis, you may be at risk of this. You should talk with your doctor if you suspect it.
You must avoid getting pregnant while you are taking topiramate. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
Si compras algún medicamento, siempre consulta con un farmacéutico que sean adecuados para tomar con tus otros medicamentos.
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Can topiramate cause problems?
Volver al contenidoAlong with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with topiramate. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Very common topiramate side-effects (these affect more than 1 in 10 people) | ¿Qué puedo hacer si experimento esto? |
Sentirse mal (náuseas) | Mantente en alimentos simples - evita comidas ricas o picantes |
Feeling sleepy, dizzy or tired | Si esto sucede, no conduzcas y no uses herramientas ni máquinas |
Diarrea | Bebe mucha agua para reponer los líquidos perdidos |
Feeling depressed | If this continues, let your doctor know (see also below) |
Nose and throat problems, tingling feelings, loss of weight | If any become troublesome, speak with your doctor for advice |
Importante: topiramate has been associated with a number of serious unwanted effects. Although these occur less commonly than the side-effects listed above, you must let your doctor know de inmediato if you notice either of the following:
Problems with your eyesight.
Mood changes, distressing or depressed thoughts, or feelings about suicide.
If you experience other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store topiramate
Volver al contenidoMantenga todos los medicamentos fuera del alcance y la vista de los niños.
Almacenar en un lugar fresco y seco, lejos del calor y la luz directos.
The oral liquid medicine keeps for one month after first opening. After this time make sure you use a new bottle. It is a good idea to write the date you opened the bottle on the label.
Información importante sobre todos los medicamentos
Volver al contenidoInformación importante sobre todos los medicamentos
Nunca tome más de la dosis prescrita. Si sospecha que usted u otra persona podría haber tomado una sobredosis de este medicamento, acuda al departamento de accidentes y emergencias de su hospital local. Lleve el envase con usted, incluso si está vacío.
Este medicamento es para ti. Nunca lo des a otras personas, incluso si su condición parece ser la misma que la tuya.
Si vas a someterte a una operación o tratamiento dental, informa a la persona que realiza el tratamiento sobre los medicamentos que estás tomando.
No guardes medicamentos caducados o no deseados. Llévalos a tu farmacia local, que se encargará de desecharlos por ti.
Si tienes alguna pregunta sobre este medicamento, consulta a tu farmacéutico.
Informar efectos secundarios de un medicamento o vacuna
Si experimenta efectos secundarios, puede reportarlos en línea a través de Yellow Card website.

¿Inseguro sobre mezclar medicamentos?
Verifica posibles interacciones entre medicamentos, suplementos y alimentos antes de tomarlos juntos.
Lecturas adicionales y referencias
- Manufacturer's PIL, Topamax® Tablets; Janssen-Cilag Ltd. The electronic Medicines Compendium. Dated October 2021.
- Manufacturer's PIL, Topamax Sprinkle® Capsules; Janssen-Cilag Ltd. The electronic Medicines Compendium. Dated October 2021.
- Medicamentos Completos BNF 89ª Edición; Asociación Médica Británica y Sociedad Real de Farmacia de Gran Bretaña, Londres.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Historial del artículo
La información en esta página está escrita y revisada por pares por clínicos calificados.
Próxima revisión: 18 de septiembre de 2026
25 Jun 2024 | Última versión

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