Topiramate
Also known as: Topamax, Topiragen, Epitomax, Topamac, Topimax
> **Important**: Never stop this medication abruptly, as it can trigger severe "rebound" seizures. Always consult your veterinarian before changing the dose. * **Administration**: Can be given with or without food. If your pet experiences stomach upset, try giving the medication with a small meal. * **Behavioral Changes**: Watch for signs of irritability, sedation, or loss of appetite, especially when starting the medication or increasing the dose. Contact your vet if these occur. * **Seizure Diary**: Keep a detailed log of any seizures (date, time, duration, and severity) to help your veterinarian determine if the medication is working. * **Commitment**: Because this drug is processed very quickly in dogs, you may need to administer it 2 to 3 times a day exactly as prescribed. * **Expectations**: The clinical use of this agent is relatively 'investigational' in veterinary patients, and it is often used when other medications have failed.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Automatisms (running fits) and focal seizure activity
- Alternative second line anticonvulsant
- Alternative treatment for refractory generalized and focal seizures
- Seizures (Initial dose)
- Seizures
- Refractory epilepsy
How it is given
Possible side effects
- GI distress (dogs)
- Inappetence (dogs, cats)
- Irritability (dogs)
- Sedation/Lethargy (cats, dogs)
- Ataxia (dogs)
- Somnolence (humans)
- Dizziness (humans)
- Acute myopia with secondary angle closure glaucoma (rare, humans)
- Calcium phosphate renal calculi (humans)
- Sedation
- Ataxia
- Anorexia
- Weight loss
- Gastrointestinal upset
Cautions & contraindications
- Hypersensitivity to topiramate
- Known hypersensitivity to topiramate
- Use with caution in patients with impaired hepatic or renal function. Topiramate can cause a hyperchloremic metabolic acidosis and reduce citrate excretion in the urine, increasing urine pH and leading to calcium phosphate renal calculi. It is an FDA Category C drug for pregnancy (teratogenic effects noted in mice and rats) and enters maternal milk; use with caution in nursing patients.
Drug interactions
- Amitriptyline: Topiramate may increase amitriptyline levels
- Carbonic Anhydrase Inhibitors (acetazolamide, dichlorphenamide): Concomitant use may increase the risk of renal stone formation
- CNS Depressants: May exacerbate the adverse effects of topiramate
- Lamotrigine: May increase topiramate levels
- Phenytoin: May decrease topiramate levels; phenytoin levels may increase
- Valproic Acid: May decrease topiramate and VPA levels
- Phenobarbital: May increase clearance and decrease plasma concentrations of topiramate
Frequently asked questions
What is Topiramate used for in pets?
> **Important**: Never stop this medication abruptly, as it can trigger severe "rebound" seizures. Always consult your veterinarian before changing the dose. * **Administration**: Can be given with or without food. If your pet experiences stomach upset, try giving the medication with a small meal. * **Behavioral Changes**: Watch for signs of irritability, sedation, or loss of appetite, especially when starting the medication or increasing the dose. Contact your vet if these occur. * **Seizure Diary**: Keep a detailed log of any seizures (date, time, duration, and severity) to help your veterinarian determine if the medication is working. * **Commitment**: Because this drug is processed very quickly in dogs, you may need to administer it 2 to 3 times a day exactly as prescribed. * **Expectations**: The clinical use of this agent is relatively 'investigational' in veterinary patients, and it is often used when other medications have failed.
Is Topiramate safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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