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Precautions

Do NOT use Topamax if:

• you are allergic to your ingredient in Topamax
• you consider a carbonic anhydrase inhibitor (eg, acetazolamide).

Contact a medical expert or physician immediately if all of these affect you.

Some medical conditions may interact with Topamax. Tell your medical provider for those who have any health concerns, especially if any of the following apply to you:

• if you're pregnant, about to conceive, or are breast-feeding
• if you take any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• for those who have allergies to medicines, foods, or any other substances
• when you have liver or kidney problems, kidney stones, osteoporosis (weak bones), or metabolic problems, you consume alcohol regularly, or you might be on a ketogenic diet
• for those who have diarrhea, lung or breathing problems, or low bicarbonate levels inside blood, or perhaps you is going to be having surgery
• when you have a history of status epilepticus (continuous seizure activity or even a series of seizures with out a full go back to consciousness)
• if you have a good reputation for mental or mood problems, or suicidal thoughts or actions.

Some medicines may connect to Topamax. Tell your medical provider if you consider every other medicines, especially any of the following:

• Anticholinergics (eg, benztropine), carbonic anhydrase inhibitors (eg, acetazolamide), haloperidol, or tricyclic antidepressants (eg, nortriptyline) because the chance of decreased sweating could be increased
• Valproic acid want . serious side effect with signs and symptoms of confusion, lethargy, and vomiting may occur
• Metformin or pioglitazone because blood glucose control could be altered; monitor your blood glucose carefully if you use Topamax with metformin or pioglitazone
• Hydrochlorothiazide because it might increase the risk of Topamax's unwanted side effects
• Carbamazepine or hydantoins (eg, phenytoin) because they may decrease Topamax's effectiveness
• Amitriptyline because the chance of its negative effects could be increased by Topamax
• Lithium because Topamax may have an effect on lithium blood levels
• Hormonal birth control (eg, contraceptive pills) or risperidone his or her effectiveness could possibly be decreased by Topamax.

This might not be a complete set of all interactions that may occur. Ask your doctor if Topamax may interact with other medicines that you take. Check with your medical provider before starting, stop, or change the dose of any medicine.

Important safety information:

• Topamax may cause drowsiness, dizziness, confusion, or trouble concentrating. These effects could possibly be worse if you go on it with alcohol or certain medicines. Use Topamax with caution. Do not drive or perform other possible unsafe tasks before you recognize how you answer it.
• Do not are drinking alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Topamax; it might add to their effects. Ask your friendly phamacist when you have questions on which medicines may cause drowsiness.
• Topamax may reduce sweating, which could raise body temperature, especially in children. This risk is greater in hot weather and/or during vigorous exercise. Drink a good amount of fluids. Dress lightly whilst in hot climates or when you exercise. Check carefully for warning signs of decreased sweating. If this occurs, promptly seek cooler or air-conditioned shelter and/or stop exercising. Seek medical assistance without delay for those who have unexplained fever, or in case you have mental or mood changes, headache, or dizziness.
• Tell your medical professional or dentist which you take Topamax before you get any medical or dentistry, emergency care, or surgery.
• Hormonal birth control (eg, contraceptive pills) may not act as well while you might be using Topamax. To prevent pregnancy, use an extra way of birth control (eg, condoms).
• Lab tests, including serum bicarbonate levels, might be performed when you use Topamax. These tests could possibly be accustomed to monitor your condition or pay attention to side effects. Be sure to keep all doctor and lab appointments.
• Use Topamax with caution in the elderly; they could possibly be more sensitive to its effects.
• Caution is required when working with Topamax in youngsters; they might be more understanding of its effects, especially decreased sweating and decreased bicarbonate levels.
• Topamax may affect growth rate in youngsters and teenagers in some cases. They may need regular growth checks while they take Topamax.
• Topamax ought to be combined with warning in children for migraines and in youngsters  younger than 2 years old for seizures; safety and effectiveness of these children haven't been confirmed.
• Pregnancy and breast-feeding: If you become pregnant, contact your doctor. You will need to discuss the rewards and perils associated with using Topamax while you're pregnant. Topamax is found in breast milk. If you are or will be breast-feeding as you use Topamax, check with your medical professional. Discuss any possible risks for your baby.