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Qudexy™ XR (topiramate) extended-release capsules and Topiramate Extended-Release Capsules are prescription medicines used:
- to treat certain types of seizures (partial-onset seizures and primary generalized tonic-clonic seizures) in adults and children 10 years of age and older,
- with other medicines to treat certain types of seizures (partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome) in adults and children 2 years and older.
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IMPORTANT SAFETY INFORMATION
Do not take Qudexy™ XR or Topiramate Extended-Release Capsules if you have metabolic acidosis and are also taking metformin (e.g., Glucophage®).
Qudexy XR and Topiramate Extended-Release Capsules can cause serious side effects, including: Eye problems. Serious eye problems include blurred vision, sudden decrease in vision with or without eye pain and redness, and a blockage of fluid that may cause increased pressure in the eye (secondary angle closure glaucoma). Decreased sweating and increased body temperature (fever). People, especially children, should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition. Increased acid level in your blood (metabolic acidosis). This may or may not cause symptoms. Symptoms may include feeling tired, decreased appetite, change in heartbeat, or trouble thinking clearly. If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may harm your baby if you are pregnant. High blood ammonia levels. High ammonia in the blood can affect mental activities, slow alertness, cause tiredness, or cause vomiting. This can also happen when Qudexy XR or Topiramate Extended-Release Capsules is taken with a medicine called valproic acid (e.g., Depakene® and Depakote®). Kidney stones. Drink plenty of fluids when taking Qudexy XR or Topiramate Extended-Release Capsules to decrease your chances of getting kidney stones. Low body temperature. Taking Qudexy XR or Topiramate Extended-Release Capsules when you are also taking valproic acid may cause a drop in body temperature to less than 95°F, tiredness, confusion, or coma. Effects on thinking and alertness. Qudexy XR and Topiramate Extended-Release Capsules may affect how you think, and can cause confusion, and problems with concentration, attention, memory, or speech. Qudexy XR and Topiramate Extended-Release Capsules may cause depression or mood problems, tiredness, and sleepiness. Dizziness or loss of muscle coordination. Call your healthcare provider right away if you have any of the above symptoms.
Like other antiepileptic drugs, Qudexy XR and Topiramate Extended-Release Capsules may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Before you take Qudexy XR or Topiramate Extended-Release Capsules, tell your healthcare provider if you have or have had depression, mood problems, or suicidal thoughts or behavior. Call a healthcare provider right away if you have thoughts about suicide or dying; have attempted to commit suicide; have new or worsening depression or anxiety; feel agitated or restless; experience panic attacks, trouble sleeping (insomnia), or new or worsening irritability; feel or act aggressive, angry, or violent; act on dangerous impulses; have an extreme increase in activity and talking (mania); or experience other unusual changes in behavior or mood.
Before taking Qudexy XR or Topiramate Extended-Release Capsules, tell your healthcare provider about any other medical conditions, including if you have had depression, mood problems, or suicidal thoughts or behavior; have kidney problems, kidney stones, or are getting kidney dialysis; have a history of metabolic acidosis (too much acid in the blood); have liver problems; have weak, brittle or soft bones (osteomalacia, osteoporosis, osteopenia, or decreased bone density); have lung or breathing problems; have eye problems, especially glaucoma; have diarrhea; have a growth problem; are on a diet high in fat and low in carbohydrates, which is called a ketogenic diet; are having surgery; are pregnant or plan to become pregnant; or if you are breastfeeding. The medicine in Qudexy XR and in Topiramate Extended-Release Capsules (topiramate) passes into your breast milk. It is not known if the medicine, topiramate, that passes into breast milk can harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take Qudexy XR or Topiramate Extended-Release Capsules.
Qudexy XR and Topiramate Extended-Release Capsules can harm your unborn baby. All women of childbearing age should talk to their healthcare providers about possible alternative treatments. If you take Qudexy XR or Topiramate Extended-Release Capsules during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. If the decision is made to use Qudexy XR or Topiramate Extended-Release Capsules, you should use effective birth control (contraception) unless you are planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking Qudexy XR or Topiramate Extended-Release Capsules.
The most common side effects include tingling of the arms and legs (paresthesia), irregular movements of the eyes (nystagmus), loss of appetite, nausea or indigestion, a change in the way foods taste, diarrhea, weight loss, nervousness, and upper respiratory tract infection. These are not all the possible side effects of Qudexy XR and Topiramate Extended-Release Capsules. For more information, ask your healthcare provider or pharmacist.
Tell your healthcare provider about any other medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Qudexy XR or Topiramate Extended-Release Capsules and other medicines may affect each other causing side effects. Especially tell your healthcare provider if you take metformin (e.g., Glucophage); valproic acid (e.g., Depakene or Depakote); any medicines that impair or decrease your thinking, concentration, or muscle coordination; birth control pills; medicines used to prevent seizures; or any other carbonic anhydrase inhibitors. Qudexy XR or Topiramate Extended-Release Capsules may make your birth control pills less effective.
Do not stop Qudexy XR or Topiramate Extended-Release Capsules without first talking to a healthcare provider. If you have epilepsy and you stop taking Qudexy XR or Topiramate Extended-Release Capsules suddenly, you may have seizures that do not stop. Your healthcare provider will tell you how to stop taking Qudexy XR or Topiramate Extended-Release Capsules slowly.
Do not drink alcohol while taking Qudexy XR or Topiramate Extended-Release Capsules. Qudexy XR or Topiramate Extended-Release Capsules and alcohol can cause serious side effects such as severe sleepiness and dizziness and an increase in seizures.
Do not drive a car, swim, climb, or operate heavy machinery until you know how Qudexy XR or Topiramate Extended-Release Capsules affects you. Qudexy XR or Topiramate Extended-Release Capsules can slow your thinking and motor skills, and may affect vision. Even when taking Qudexy XR or Topiramate Extended-Release Capsules, some patients with epilepsy will continue to have unpredictable seizures.
If you are unable to swallow Qudexy XR or Topiramate Extended-Release Capsules whole, the medicine may be sprinkled on a spoonful of soft food like applesauce. Do not store the food and medicine mixture to use later or crush or chew the food and medicine mixture before swallowing.
This safety information is not all-inclusive. For additional important information, talk to your healthcare provider and read the Medication Guide for Qudexy XR and Topiramate Extended-Release Capsules. You can also visit www.upsher-smith.com or call 1-888-650-3789.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.