Topiramate ER (Eqv-Trokendi XR)

Topiramate ER (Eqv-Trokendi XR) is used by itself or with other medications to treat certain types of seizures in adults and children who are at least 2 years old. Some forms of the extended-release capsule of Topiramate ER (Eqv-Trokendi XR) are only for use in adults and children who are at least 6 years old.

Topiramate ER (Eqv-Trokendi XR) is also used to help prevent migraine headaches in adults and children who are at least 12 years old.

Topiramate ER (Eqv-Trokendi XR) may also be used for other reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take Topiramate ER (Eqv-Trokendi XR) with or without food.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Drink plenty of liquids while you are taking Topiramate ER (Eqv-Trokendi XR) to help prevent kidney stones.

Some capsules may be swallowed whole or opened and sprinkled on a small amount of soft food. Certain extended-release capsules must be swallowed whole and must not be opened, crushed, chewed, dissolved, or sprinkled on food. Follow the instructions that come with your medicine.

Doses are based on weight in children and teenagers. Your child's dose may change if the child gains or loses weight.

You may need blood tests before and during treatment with Topiramate ER (Eqv-Trokendi XR), and your next dose may be changed based on the results. Your doctor will need to check your progress on a regular basis. Keep all follow-up visits to your doctor.

You should not stop using Topiramate ER (Eqv-Trokendi XR) suddenly. Follow your doctor's instructions about tapering your dose.

Call your doctor if your symptoms do not improve, or if they get worse.

Store tightly closed at room temperature, away from moisture, heat, and light. Do not allow the liquid medicine to freeze. Throw away any unused liquid medicine 90 days after opening the bottle.

Topiramate ER (Eqv-Trokendi XR) may cause vision problems that can lead to permanent vision loss. Call your doctor immediately if you experience any eye pain, redness, or changes in your vision.

Topiramate ER (Eqv-Trokendi XR) may cause decreased sweating and increased body temperature. Children and those in hot weather may be more likely to experience this side effect.

Some individuals may have thoughts of suicide while taking Topiramate ER (Eqv-Trokendi XR). Inform your doctor right away if you notice any sudden changes in mood or behavior, or have thoughts about suicide.

Topiramate ER (Eqv-Trokendi XR) can decrease bone mineral density, which may raise the risk of developing osteoporosis when used in children for long periods of time.

You should not use Topiramate ER (Eqv-Trokendi XR) if you are allergic to it.

You may not be able to use certain extended-release forms of Topiramate ER (Eqv-Trokendi XR) if you drank alcohol within the past 6 hours or plan to drink alcohol within 6 hours after taking the medicine.

Tell your doctor if you have or have ever had:

• glaucoma or other eye problems;
• high blood levels of ammonia;
• metabolic acidosis (high levels of acid in your blood);
• lung disease, breathing problems;
• depression, mood changes, or suicidal thoughts or actions;
• a growth problem;
• diarrhea;
• a planned surgery;
• kidney stones;
• a bone disorder that causes soft or weak bones or low bone mineral density;
• follow a ketogenic diet (high-fat, high-protein, low-carb);
• liver disease; or
• kidney disease (or if you are on dialysis).

Taking Topiramate ER (Eqv-Trokendi XR) may increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children. Ask your doctor about your individual risk.

Some people have thoughts about suicide while taking Topiramate ER (Eqv-Trokendi XR). Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Tell your doctor if you are pregnant or plan to become pregnant. Your doctor should determine whether you need Topiramate ER (Eqv-Trokendi XR). Taking Topiramate ER (Eqv-Trokendi XR) during pregnancy may cause birth defects or medical problems in the baby. There may be other medications that are safer to use during pregnancy.

You must use effective birth control while using Topiramate ER (Eqv-Trokendi XR). Topiramate ER (Eqv-Trokendi XR) can make certain birth control less effective. Ask your doctor about other birth control options.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of Topiramate ER (Eqv-Trokendi XR) on the baby.

Ask a doctor if it is safe to breastfeed while using Topiramate ER (Eqv-Trokendi XR).

Get emergency medical help if you have signs of an allergic reaction (hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Topiramate ER (Eqv-Trokendi XR) may cause serious side effects. Call your doctor at once if you have:

• changes in your menstrual bleeding;
• a skin rash, no matter how mild;
• dizziness or loss of coordination;
• blurred vision, eye pain or redness, seeing halos around lights, or sudden vision loss (can be permanent if not treated quickly);
• confusion, problems with thinking or memory, trouble concentrating, problems with speech;
• decreased sweating, feeling very hot;
• signs of a kidney stone--pain in your side or lower back, blood in your urine, painful or difficult urination;
• signs of metabolic acidosis--confusion, vomiting, lack of energy, irregular heartbeats; or
• high levels of ammonia in your blood--vomiting, unexplained weakness, feeling like you might pass out, change in your mental state.

Topiramate ER (Eqv-Trokendi XR) can affect growth in children. Your child's height and weight may be checked often. Tell your doctor if your child is not growing at a normal rate while using Topiramate ER (Eqv-Trokendi XR) long-term.

Common side effects of Topiramate ER (Eqv-Trokendi XR) may include:

• dizziness, drowsiness, tiredness, slow reactions;
• problems with speech, memory, or vision;
• numbness, tingling, burning pain in your arms and legs, decreased sensation (especially in the skin);
• changes in your sense of taste, feeling nervous;
• nausea, diarrhea, stomach pain, loss of appetite;
• fever, weight loss; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Take the medicine as soon as you remember, but skip the missed dose if your next dose is due in less than 6 hours. Do not take two doses at the same time.

For the extended-release capsule: Call your doctor for instructions if you miss a dose. Do not take two doses at the same time.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An overdose can be fatal.

Do not drink alcohol. Dangerous side effects could occur. Certain extended-release forms of Topiramate ER (Eqv-Trokendi XR) must not be taken within 6 hours before or after drinking alcohol.

Avoid becoming overheated or dehydrated in hot weather. Topiramate ER (Eqv-Trokendi XR) can raise body temperature and lower sweating, which can lead to life-threatening dehydration (especially in children).

Avoid using a ketogenic or "ketosis" diet (high in fat, low in carbohydrates) while you are taking Topiramate ER (Eqv-Trokendi XR).

Avoid driving or doing dangerous activities until you know how Topiramate ER (Eqv-Trokendi XR) will affect you. This medicine may cause dizziness, blurred vision, balance or memory problems, which can impair your reactions and lead to falls, accidents, or severe injuries.

Using Topiramate ER (Eqv-Trokendi XR) with other medications that cause drowsiness can make this effect worse. Talk to your doctor before using opioid medication, a sleeping pill, a muscle relaxant, or medications for anxiety or seizures.

Inform your doctor about all your other medications, especially:

• hydrochlorothiazide;
• acetazolamide, or other glaucoma medications, including eye drops;
• birth control containing hormones (such as pills, implants, patches, or injections); or
• anticonvulsants (antiepileptics) -- phenytoin, carbamazepine, zonisamide, valproic acid.

This list is not complete. Other medications may influence how Topiramate ER (Eqv-Trokendi XR) works, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.