Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Topiramate.

Ammonia: Topiramate may cause elevated levels of ammonia in the blood, which can cause changes in mental alertness. If you have symptoms of decreased alertness, confusion, tiredness, vomiting, or a low body temperature (less than 35°C), contact your doctor immediately.

Birth control: Topiramate has been shown to affect birth control pills that contain low doses of estrogen. If you are taking birth control pills, your pill should contain no less than 30 µg of estrogen. Report any changes in bleeding patterns to your doctor.

Depression: Topiramate may contribute to mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how Topiramate may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Topiramate, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Topiramate, contact your doctor as soon as possible.

Drowsiness/reduced alertness: Topiramate can cause difficulty with concentration, speech or language problems, and drowsiness or fatigue. If you are taking Topiramate you should not drive or operate machinery until you have had a chance to see if it affects your mental or physical performance.

Heat regulation: For some people, especially children, topiramate may cause decreased sweating and increased body temperature. Let your doctor know if you or a child taking Topiramate experiences these symptoms. You should make sure you are properly hydrating during exposure to warm temperatures, as well as before and during exercise.

Kidney function: Kidney Disease or reduced kidney function may cause Topiramate to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Topiramate may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Topiramate, and whether any special monitoring is needed.

Kidney stones: Approximately 2% of people taking topiramate develop kidney stones. Men seem to be at greater risk for this. Be sure to drink plenty of fluids while taking Topiramate in order to reduce the risk of kidney stone formation. If you experience pain in the kidney or flank areas, contact your doctor to have this investigated.

Laboratory tests: Topiramate may decrease sodium bicarbonate levels and lead to metabolic acidosis. If you experience shallow, rapid breathing, unusual tiredness and loss of appetite, contact your doctor. Sodium bicarbonate levels should be monitored by your doctor with blood tests, while you are taking topiramate.

Liver function: Liver disease or reduced liver function may cause Topiramate to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Topiramate may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Topiramate, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Topiramate.

Suicidal or agitated behaviour: People taking Topiramate may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting Topiramate. If you experience these side effects or notice them in a family member who is taking Topiramate, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Topiramate.

Stopping treatment: If you are taking topiramate to control seizures, it should be stopped gradually to decrease the risk of seizures. If it is necessary to stop taking topiramate, discuss with your doctor the best way to reduce your dose gradually. Do not stop taking Topiramate without talking to your doctor.

Vision changes: Topiramate may cause the symptoms of Glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how Topiramate may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Topiramate, and whether any special monitoring is needed. If you are taking topiramate you should immediately report blurred vision or painful and red eyes to a doctor. If left untreated, these symptoms can lead to permanent vision loss.

Pregnancy: Topiramate may cause harm to the developing baby if it is taken by a woman while she is pregnant. Topiramate should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Topiramate, contact your doctor immediately.

Breast-feeding: Topiramate may pass into breast milk. If you are breast-feeding and taking topiramate, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: Topiramate can be used in children aged 2 and older for seizures. The safety and effectiveness of using Topiramate have not been established for children under the age of 2. The safety and effectiveness of using Topiramate to prevent migraine headaches has not been established for children less than 18 years of age.