Prescription medication · Anticonvulsant
topiramate
Also sold as Topamax. Topiramate can be used alone or with other medicines to treat certain types of seizures in people 2 years and older.
Data updated 2026-05-15
- 90,083
- FDA reportsOften reported
- 30
- InteractionsSeveral interactions
- 99% less
- Generic vs brandHuge savings
- In shortage
- FDA status
What the data shows
topiramate (Topamax) is a prescription Anticonvulsant, more reported than most tracked drugs (90,083 FDA reports), whose generic costs a fraction of the brand (about 99% less).
Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.
topiramate (Topamax) is a prescription Anticonvulsant. Topiramate can be used alone or with other medicines to treat certain types of seizures in people 2 years and older.
Topiramate is a medicine that can help prevent seizures and migraines. It works by calming the brain.
Verify with FDA → · CMS NADAC pricing →
Drug Shortage Alert
topiramate is currently listed as to be discontinued by the FDA. Affected manufacturer: Upsher-Smith Laboratories, LLC.
View all drug shortages →Drug Pricing (NADAC)
Brand Price
$17.12/unit
Generic Price
$0.06/unit
Generic Savings
99%
Generic Available
Yes (26 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
NADAC price trail: TOPIRAMATE 100 MG TABLET
Same CMS presentation as the headline generic unit price above (3 effective dates). Adjacent % compares consecutive NADAC releases for this description only, not a patient out-of-pocket quote. Latest step: +1.1% vs prior release.
| Effective | NADAC / unit | vs prior | NDCs |
|---|---|---|---|
| February 21, 2024 | $0.0674/EA | - | 2 |
| April 17, 2024 | $0.0559/EA | -17% | 2 |
| December 18, 2024 | $0.0565/EA | +1.1% | 22 |
What it does
Topiramate can be used alone or with other medicines to treat certain types of seizures in people 2 years and older.
Common side effects
Tingling or numbness, Loss of appetite, Weight loss
Key warnings
Topiramate can cause serious side effects.
The sections below are summarized in plain English from topiramate's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.
How It Works
Topiramate works by reducing the excitability of brain cells. It also increases the activity of a brain chemical called GABA. These actions help to prevent seizures and migraines.
Side Effects (from patient reports)
Based on 90,083 FDA adverse event reports.
Most-reported reactions
Adverse reactions in FAERS for topiramate, by number of reports
- Headache
Headache
6,464 reports
- Nausea
Nausea
5,710 reports
- Fatigue
Fatigue
5,293 reports
- Pain
Pain
4,485 reports
- Migraine
Migraine
4,373 reports
- Dizziness
Dizziness
4,123 reports
- Seizure
Seizure
3,757 reports
- Diarrhoea
Diarrhoea
3,600 reports
- Vomiting
Vomiting
3,542 reports
- Depression
Depression
3,541 reports
What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.
Reports over time
Adverse-event reports filed for topiramate each year to the FDA Adverse Event Reporting System (FAERS).
Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.
Where topiramate sits
topiramate has more FDA adverse-event reports than 84% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.
Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is topiramate; the line is the median (50th percentile).
FDA Adverse Event Report Analysis
Detailed analysis of 90,083 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2001–2025.
Total Reports
90,083
Reports Mentioning Death
6,485
7.2% of reports — not proof of cause
Hospitalization Reports
22,919
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 3 | HEADACHE | 6,464 |
| 4 | NAUSEA | 5,710 |
| 5 | FATIGUE | 5,293 |
| 6 | PAIN | 4,485 |
| 7 | MIGRAINE | 4,373 |
| 8 | DIZZINESS | 4,123 |
| 9 | SEIZURE | 3,757 |
| 10 | DIARRHOEA | 3,600 |
| 11 | VOMITING | 3,542 |
| 12 | DEPRESSION | 3,541 |
| 14 | WEIGHT DECREASED | 2,954 |
| 15 | WEIGHT INCREASED | 2,936 |
| 16 | DYSPNOEA | 2,878 |
| 17 | PARAESTHESIA | 2,861 |
| 18 | CONDITION AGGRAVATED | 2,835 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Topiramate can cause serious side effects. It can cause vision problems, including sudden nearsightedness and glaucoma. It can decrease sweating and increase body temperature, especially in children. It can cause metabolic acidosis (too much acid in the blood). It may increase the risk of suicidal thoughts or actions. It can affect thinking and coordination. It can harm an unborn baby. It can decrease bone mineral density. It can slow growth in children. It can cause serious skin reactions. It can cause kidney stones. If you experience any of these, contact your doctor immediately.
Known Drug Interactions
7.2 Other Carbonic Anhydrase Inhibitors Concomitant use of topiramate, a carbonic anhydrase inhibitor, with any other carbonic anhydrase inhibitor (e.g., zonisamide or acetazolamide) may increase the severity of metabolic acidosis and may also increase the risk of kidney stone formation.
Mechanism: Both drugs block the same enzyme, which can make your blood too acidic. This combination also makes it more likely that you will develop kidney stones.
Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide Drugs that Reduce Metformin Clearance Clinical Impact: Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2]/multidrug and toxin extrusion [MATE] inhibitors) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical Pharmacology (12.3) ] .
Mechanism: Topiramate can stop your kidneys from clearing metformin properly, which may cause the drug to build up to dangerous levels.
7 DRUG INTERACTIONS Table 3: Clinically Significant Drug Interactions with SEGLUROMET Carbonic Anhydrase Inhibitors Clinical Impact: The risk of lactic acidosis may increase due to concomitant use of Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) with metformin.
Mechanism: Topiramate affects how the body handles acid, which can increase the risk of a serious condition called lactic acidosis when combined with metformin.
7.5 Hydrochlorothiazide (HCTZ) Topiramate C max and AUC increased when HCTZ was added to topiramate.
Mechanism: Adding this water pill can cause the levels of topiramate in your blood to increase.
7.8 Amitriptyline Some patients may experience a large increase in amitriptyline concentration in the presence of topiramate and any adjustments in amitriptyline dose should be made according to the patient's clinical response and not on the basis of plasma levels [see Clinical Pharmacology ( 12.3 )] .
Mechanism: Topiramate can cause the amount of amitriptyline in your blood to rise significantly.
This is a plain-language summary of FDA-label interaction records and does not provide individual medication-combination directions.
Common Questions
Can I stop taking topiramate suddenly?
Will topiramate affect my ability to drive?
Can I drink alcohol while taking topiramate?
Does topiramate interact with birth control pills?
Can topiramate cause weight loss?
What should I do if I have vision problems while taking topiramate?
Can topiramate cause kidney stones?
Will topiramate affect my mood?
Can children take topiramate?
What should I do if I think I have taken too much topiramate?
What are the common side effects of topiramate?
Does topiramate interact with other medications?
What drug class is topiramate?
Is there a generic version of topiramate?
What pregnancy or breastfeeding source fields are listed for topiramate?
Is topiramate currently in shortage?
Related Medications in Anticonvulsant
Other drugs grouped near topiramate - same-class peers and common alternatives.
brivaracetam
Briviact
Brivaracetam is a medicine used to treat partial-onset seizures.
Compare with topiramate →
cannabidiol
Epidiolex
Epidiolex is a medicine that contains cannabidiol.
Compare with topiramate →
carbamazepine
Tegretol
Carbamazepine is a medicine used to control seizures and treat nerve pain.
Compare with topiramate →
cenobamate
Xcopri
Xcopri is a medicine used to treat partial-onset seizures in adults.
Compare with topiramate →
clobazam
Onfi, Sympazan
Clobazam oral suspension is a medicine used with other medicines to treat seizures caused by Lennox-Gastaut syndrome.
Compare with topiramate →
Compare beyond drug class
Nationwide peers by FAERS volume & death-report share
Two PlainMeds-derived comparison paths for topiramate: nearest FDA FAERS report volume and nearest death-report share among drugs with at least 1,000 logged reports, excluding same-class neighbors listed above. Counts reflect reporting volume, not proven individual harm.
Similar FAERS report volume
Nearest drugs by total FAERS reports. This record: 90,083.
Similar death-report share
Nearest drugs by FAERS death-report share. This record: 7.20%.
- deutetrabenazine Δ 0.00 pts · 6,445 reports · VMAT2 Inhibitor 7.20%death share
- fenofibrate Δ 0.02 pts · 48,091 reports · Fibrate 7.22%death share
- brinzolamide Δ 0.03 pts · 8,461 reports · Carbonic Anhydrase Inhibitor (Ophthalmic) 7.23%death share
- golimumab Δ 0.03 pts · 82,622 reports · TNF-Alpha Inhibitor (Biologic) 7.16%death share
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
FDA bioequivalence and label-record context for narrow therapeutic index medicines
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for topiramate
The FDA label for topiramate (sold under brand names such as Topamax) classifies it as a prescription-only medication in the Anticonvulsant class. Topiramate can be used alone or with other medicines to treat certain types of seizures in people 2 years and older. Official labeling lists 18 commonly reported side effects, including Tingling or numbness, Loss of appetite, Weight loss.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 90,083 voluntary reports. The database also lists 30 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.06 versus $17.12 for the brand - a 99% generic savings.
Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information are separate source-record fields. This page is a public FDA/CMS registry and does not provide medical, treatment, substitution, or medication-change directions.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. This registry does not provide medication decisions.
Last updated: December 19, 2024
PlainMeds is rendered directly from FDA openFDA/FAERS extracts, DailyMed labels, and CMS drug-pricing files, no number is typed in by an editor. FAERS counts, recalls, shortages, and price figures on this page are queried live from those federal extracts. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of 2026-05-15. Primary sources: openFDA / FAERS, DailyMed and CMS Part B ASP.
Read our methodology - how this data is sourced, computed, and verified.
Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled from the source snapshot dated . See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a data issue.
All federal data sources used on this page
- FDA Orange Book - approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed - NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) - post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm - standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files - federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database - current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages