If you are:
Not Recommended: DATA FROM PREGNANCY REGISTRY SHOW INCREASED RISK OF OROFACIAL CLEFT
Precaution: MONITOR FOR SIGNS OF TOXICITY; MAY CAUSE SEDATION,IRRITABILITY,FEEDING PROBLM
An adult over 60:
management or monitoring precaution: Renal-Decrease dose for CrCl < 70 mL/min. to minimize CNS toxicities. Neuro/Psych-Can cause ataxia, impaired psychomotor function, syncope, and increase risk for additional falls in those predisposed. Vision-Visual field defects have been reported in patients receiving topiramate independent of elevated intraocular pressure. In clinical trials, most of these events were reversible after topiramate discontinuation.
Giving Topamax to a child under 12:
management or monitoring precaution: Risk of acidosis, hyperammonemia, oligohydrosis and rarely angle closure glaucoma. Monitor serum bicarbonate, signs of encephalopathy (ammonia level), changes in behavior and vision, and check growth rate.
Severe Precaution: Potential risk of metabolic acidosis, slowed growth, infection, hyperthermia, oligohidrosis, increased creatinine, hyperammonemia, secondary angle closure glaucoma. Efficacy not demonstrated age <2 years.