Patient/Family Teaching

• Instruct patient to take topiramate exactly as directed. Take missed doses as soon as possible but not just before next dose; do not double doses. Notify health care professional if more than 1 dose is missed. Medication should be gradually discontinued to prevent seizures and status epilepticus

• May cause decreased sweating and increased body temperature. Advise patients, especially parents of pediatric patients, to provide adequate hydration and monitoring, especially during hot weather

• May cause dizziness, drowsiness, confusion, and difficulty concentrating. Caution patients to avoid driving or other activities requiring alertness until response to medication is known

• Advise patient to maintain a fluid intake of 2000–3000 ml of fluid/day to prevent the formation of kidney stones

• Instruct patient to notify health care professional immediately if periorbital pain or blurred vision occur. Medication should be discontinued if ocular symptoms occur. May lead to permanent loss of vision

• Caution patient to make position changes slowly to minimize orthostatic hypotension

• Advise patient not to take alcohol or other CNS depressants concurrently with this medication

• Advise patient to use a nonhormonal form of contraception while taking topiramate

• Instruct patient to notify health care professional of medication regimen before treatment or surgery

• Advise patient to use sunscreen and wear protective clothing to prevent photosensitivity reactions

• Advise patient to carry identification describing disease and medication regimen at all times

• Refer patient/family to Manic-Depressive and Depressive Association for support

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