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Topiramate for Weight Loss

Supportive Care

Often used for:

Weight loss, seizures, migraine prevention, mood disorders

This information is specific to the use of topiramate for weight loss. For additional information on topiramate, please talk to your health care provider.

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What is topiramate?

Topiramate is a medicine used to help patients lose extra body weight in addition to other conditions. For weight loss, it works by decreasing appetite and reducing the amount of food eaten throughout the day. Topiramate may also affect how the body uses energy, which can lead to weight loss.

This medicine is often used along with a healthy eating plan and regular exercise.

Your doctor may start you on a low dose of topiramate and slowly increase it to reduce the risk of side effects. You may have blood tests to check your kidney, liver, and overall health while taking this medicine.  

This medicine is often given along with another medicine called phentermine. The combination of the 2 medicines may be more effective for weight loss.

Brain

May be given as a tablet by mouth 

 
Brain

May be given as a liquid by mouth

 
Brain

May be given as capsule or granules by mouth

 
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Possible side effects

  • Dizziness
  • Drowsiness and fatigue
  • Abdominal (belly) pain 
  • Nausea
  • Changes in taste 
  • Problems with thinking or memory 
  • Vision changes
  • Lower back pain
  • Muscle pain or weakness
  • Tremor (shaking of the body)
  • Numbness or tingling of the hands or feet
  • Dry mouth
  • Rash
  • Constipation or diarrhea
  • Mood changes
  • Trouble sleeping
  • Decreased sweating
  • Kidney stones
  • Changes to bones (decreased bone mineral density)

Call your care team right away if you have symptoms of an allergic reaction. These may include: rash, hives, itching, runny nose, fever, chills, headache, muscle ache, shortness of breath, coughing, tightness in the throat, swelling of the face or neck, dizziness, low blood pressure, or pain in the chest, side, or back.

Not all patients who take topiramate will have these side effects. Common side effects are in bold, but there may be others. Report any symptoms or side effects to your health care provider or pharmacist. 

Find more information on side effects.

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Tips for patients and families

Be sure to discuss all questions and instructions with your health care provider or pharmacist. 

  • Topiramate works best when used along with a nutrition and exercise program. Avoid high-fat, low-carbohydrate diets while taking topiramate.
  • Drink plenty of water to avoid dehydration and reduce the chance of developing kidney stones.
  • This medicine may reduce your ability to regulate body temperature. Talk to your care team about physical activity and how you can be physically active while taking this medicine. 
  • Watch for changes in your mood or mental health, such as worsening depression, anxiety, agitation, irritability, panic attacks, and trouble sleeping.
  • Seek medical help right away if you have any suicidal thoughts or actions or signs of self-harm.
  • Tell your care team if you are sexually active, pregnant, or breastfeeding.
  • This medicine may make birth control pills and other hormone-based birth control methods less effective. Sexually active patients should use another form of birth control, like condoms, to prevent pregnancy while taking this medicine.
  • Do not stop taking topiramate suddenly. Your health care provider will help you stop the medicine gradually.

Topiramate at home:

  • This medicine has several dosage forms. Take as directed by your care team.
  • Tablets: Swallow tablets whole with water. Do not crush, chew, or break before swallowing. 
  • Capsules: Swallow capsules whole or open and sprinkle on soft food such as apple sauce, oatmeal, or yogurt. Eat the food mixture immediately without chewing.
  • Liquid: Shake well before use. Use the measuring device that comes with the medicine. 
  • In case of a missed dose, take the missed dose as soon as possible. If it is near the time for the next dose, skip the missed dose. Do not take 2 doses at the same time. 
  • Store at room temperature in a dry place. Do not store in a bathroom.

Learn more about Topiramate

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency. 

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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Reviewed: January 2026