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 Capsule, Sprinkle 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.