Frequently Asked Questions
About TOPAMAX
What's different about TOPAMAX ?
How does TOPAMAX work?
How long will it take for TOPAMAX to work?
Will I still need to take other migraine
medications?
Can I take TOPAMAX with other prescription
medications?
How long has TOPAMAX been available in the U.S.?
How is TOPAMAX dosed?
What if I miss a dose of TOPAMAX?
How should TOPAMAX tablets be stored?
Do I need to take TOPAMAX with food?
What TOPAMAX side effects might I experience?
Could I experience hair loss while taking TOPAMAX?
Could I experience eye problems while taking
TOPAMAX?
Is TOPAMAX safe to take while pregnant?
Is TOPAMAX safe to take while breast-feeding?
How should TOPAMAX be discontinued?
About Migraines
What causes migraines?
How do I know if I am having a migraine or just a
bad headache?
Should I talk to my healthcare professional?
What steps can I take to manage my migraines
better?
Where can I go for more information?
What's different about TOPAMAX?
Unlike medicine you take when you feel migraine headache pain coming
on, TOPAMAX is a daily prescription medication that helps keep
migraines from starting in the first place so you can get fewer of
them to think about.
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How does TOPAMAX work?
Although the exact way TOPAMAX works is unknown, it's believed to
help "calm" overexcitable nerve cells in the brain so they don't send
out the signals that can cause migraines.
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How long will it take for TOPAMAX to work?
Clinical studies found that TOPAMAX began reducing the frequency of migraines at 1 month and showed sustained improvement throughout the 6-month studies.
To achieve best results, TOPAMAX should be taken for 2 to 3 months
and then its effectiveness can be determined.
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Will I still need to take other migraine medications?
While TOPAMAX may help reduce the number of migraines you suffer,
some patients could still have an occasional migraine attack. For
this reason, your healthcare professional might prescribe an
additional medication along with TOPAMAX as part of a treatment
program.
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Can I take TOPAMAX with other prescription medications?
Tell your healthcare professional about all the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements. TOPAMAX and certain other medicines can affect each other. Sometimes the dose of some of your other medicines or TOPAMAX will have to be adjusted. Especially, tell your healthcare professional if you are taking:
- Other medicines that impair or decrease your thinking, concentration, or muscle coordination (e.g. central nervous system depressant medicines)
- Birth control pills. TOPAMAX may make your birth control pills less effective. Tell your healthcare professional if your menstrual bleeding changes while you are taking birth control pills and TOPAMAX.
Keep a list of all the medicines you take. Show this list to your
healthcare professionals and pharmacists before you start a new
medicine.
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How long has TOPAMAX been available in the U.S.?
TOPAMAX has been available in the U.S. since 1996.
Worldwide, more than 4 million patients have been treated with
TOPAMAX (regardless of condition). Like many other migraine
preventive medications, TOPAMAX was initially studied for another
medical condition and was then approved in the U.S. in 2004 for use in reducing
migraine frequency.
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How is TOPAMAX dosed?
The rule with TOPAMAX is to "start low and go slow." That is, your
healthcare professional will adjust your medication. You'll start
with a low dose and then slowly increase the amount of TOPAMAX you
take until you reach the dosage that works best for you. Like many
other medications, TOPAMAX needs time to build up to the right level
in your bloodstream before it is completely effective, so remember to
be patient. For most patients, the recommended dose of TOPAMAX for
the prevention of migraine headache is 50 mg twice a day.
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What if I miss a dose of TOPAMAX?
If you miss a single dose of TOPAMAX, take it as soon as you can.
However, if you are within 6 hours of taking your next scheduled
dose, wait until then to take your usual dose of TOPAMAX, and skip
the missed dose. Do not double your dose. If you have missed more
than one dose, you should call your healthcare professional for
advice.
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How should TOPAMAX Tablets be stored?
Store TOPAMAX tablets in tightly closed containers at room temperature, 59°F to 86°F (15°C to 30°C). Protect from moisture.
Store TOPAMAX sprinkle capsules in tightly closed containers at or below 77°F (25°C). Protect from moisture.
Keep TOPAMAX and all medicines out of the reach of children.
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Do I need to take TOPAMAX with food?
TOPAMAX can be taken with or without food.
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What TOPAMAX side effects might I experience?
Like most other over-the-counter and prescription medications,
TOPAMAX may cause side effects. Side effects with TOPAMAX are mostly
mild or moderate, and occurred most often during the initial phase of
therapy. While these side effects vary for everyone, most people
continue their TOPAMAX therapy. To read a list of the most common
side effects see the bottom of every page throughout this site. To
view a description of TOPAMAX side effects,
click
here.
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Could I experience hair loss while taking TOPAMAX?
Hair loss (alopecia) has been reported as a side effect of TOPAMAX.
There is not enough information to predict the duration and severity
of this side effect for individual patients.
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Could I experience eye problems while taking TOPAMAX?
Call your healthcare professional right away if you have a loss in vision or get eye pain. These problems can lead to blindness if not treated right away. Your healthcare professional will probably stop TOPAMAX and may recommend other therapy.
Before taking TOPAMAX, tell your healthcare professional if you have eye problems, especially glaucoma. TOPAMAX may cause eye problems which can be serious. Serious eye problems include any decrease in vision (acute myopia or maculopathy) with or without eye pain, and a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma).
In clinical trials of TOPAMAX at doses up to 200 mg/day for migraine
prevention, certain vision disorders (abnormal vision, blurred
vision, conjunctivitis) were reported in ≤4% of adults. Abnormal
accommodation and eye pain were also reported in adults in the
clinical trials.
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Is TOPAMAX safe to take while pregnant?
The safety of TOPAMAX in pregnancy has not been established. TOPAMAX
should be given during pregnancy only upon the recommendation of your
healthcare professional and only if the potential benefit outweighs
the potential risk to the fetus. Talk to your healthcare professional
if you are pregnant or considering becoming pregnant while on
TOPAMAX.
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Is TOPAMAX safe to take while breast-feeding?
TOPAMAX may be excreted into the breast milk. Therefore, it is important to speak to your healthcare professional before considering breast-feeding while on TOPAMAX. He or she will determine if the potential benefit outweighs the potential risk to the infant.
How should TOPAMAX be discontinued?
Do not stop taking your medicine without talking to your healthcare
professional first. Your healthcare professional will tell you how to
slowly stop taking TOPAMAX. In clinical trials of TOPAMAX, daily
dosages were decreased gradually.
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What Causes Migraines?
No one knows exactly why migraines happen, but it's thought that a
series of events begins with the excitement of nerve cells in the
brain. These overexcitable nerve cells then send out impulses to the
blood vessels in the brain. The nerve releases substances that cause
inflammation and swelling of the blood vessels resulting in
throbbing.
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How do I know if I am having a migraine or just a bad headache?
Migraines are not always easy to detect. That's why you should always let your healthcare professional identify your symptoms.
Tension headaches are the most common type of headache. Most people describe these headaches as a mild or moderate pressing, or tightening, head pain. Typically, tension headaches respond well to over-the-counter treatments. Unlike migraines, they are not accompanied by nausea or light and sound sensitivity. Also, normal activity will not typically aggravate them.
Migraine headaches, on the other hand, often feature:
- Throbbing head pain
- Worsening pain with routine activity
- Nausea and/or vomiting
- Light and sound sensitivity
Often, people with watery eyes, runny nose, nasal congestion and
headache may think they have a sinus headache. What they may be
experiencing is a migraine. Nearly half of all migraine patients
experience ocular or nasal symptoms, along with head pain. That's why
it's always critical to talk to your healthcare professional.
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Should I talk to my healthcare professional?
Your healthcare professional is always the best person to review your
medical history, understand your migraine patterns, and recommend
treatment. Of course, you are a partner in your migraine management.
That's why it's important to do your part. Prepare for your
appointment by bringing your migraine diary and completed discussion
guide. This will help you get the most from your appointment.
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What steps can I take to manage my migraines better?
A migraine is triggered under specific conditions. Migraine patients get headaches sooner than other people because they have less resistance to the triggers that can aggravate, or stimulate a response.
Different people respond to different triggers, but the most common include:
- Dietary factors (irregular meal patterns, missing meals, sweets, starchy foods, too much caffeine)
- Sleep disturbances (irregular sleep patterns, too much or too little sleep)
- Emotional factors (excitement, anger, fear, anxiety, stress, letdowns)
- Environmental factors (weather changes, bright or glaring lights, loud noise, strong odors)
- Alcohol (wine, champagne, beer, liquors)
- Food additives (such as MSG and nitrates that are found in pepperoni, luncheon meats, and hot dogs)
- Hormone cycles or changes (menstruation, oral contraceptives, estrogen replacement)
- Medication overuse (frequent use of over-the-counter or prescription pain relievers)
And you can begin to understand your individual triggers better by
tracking them with a
migraine
diary.
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Where can I go for more information?
American
Headache Society Committee for Headache Education (ACHE)
Consumer-friendly site where you'll find discussion groups and a
handy physician search tool.
National
Headache Foundation
Some of the latest research and treatment developments, educational
resources, and events.
American
Academy of Neurology
Valuable resource for medical specialists worldwide who are committed
to improving the care of patients with neurological diseases
