Patient/caregiver was educated on how to take Topiramate as follows:

1. Take this medication as ordered by your physician. Do not change the dose and frequency on this medication without consulting your doctor. Take the medication dose for the duration prescribed without fail.
2. Take the medication dose at the same time, every day, to avoid forgetting the intake of medication. Taking the medication at regularly spaced intervals help maintain appropriate blood levels of topiramate needed for control of seizures.
3. Topiramate may be taken with food, as taking the medication with some food can help avoid the unpleasant gastrointestinal symptoms of nausea and vomiting. Liberal intake of fluid, atleast 8-10 glasses a day, during topiramate intake, can contribute significantly to prevent development of toxic side-effects and complications due to the medication.
4. Topiramate intake can induce some dizziness. Also, topiramate use can result in a side-effect of increased ammonia in the blood, which also contributes to increased nausea, confusion, and dizziness. Starting topiramate on a low dose and gradually increasing it to the desired dose can help accommodate to the dizzy symptoms. If the confusion and dizziness become bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by topiramate.
5. Do not take topiramate with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the confusion caused by topiramate. A number of OTC cough medications, antihistamines, and antianxiety medications, can potentiate the confusion caused by topiramate and so, must be avoided taking along with topiramate.
6. Take the topiramate regular tablet as a whole, using a glass of water. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You can also crush the regular tablet and sprinkle the powder on a spoon of apple sauce or jello or pudding, to facilitate an easy swallow.
7. If you are prescribed topiramate sprinkle capsule containing small crystals of the medication, open the capsule and sprinkle the contents on a spoonful of apple sauce or jello or pudding. Swallow the apple sauce or pudding with the contents of capsule sprinkled over it, without chewing the contents in the mouth. Chewing these crystals in the mouth can result in rapid release and absorption of the medication into the blood stream, thus resulting in toxicity.
8. If you are prescribed topiramate extended-release capsule, try to swallow the capsule as a whole, with a glass of water. If you encounter difficulty swallowing the whole extended-release capsule, you may open the capsule and sprinkle the contents on a spoonful of apple sauce or jello or pudding. Swallow the apple sauce or pudding with the contents of capsule sprinkled over it, without chewing the contents in the mouth. Chewing these contents in the mouth can result in rapid release and absorption of the medication into the blood stream, thus resulting in toxicity.
9. Topiramate can take some time to fairly adjust to your body and reach a therapeutic level in your blood, before preventing seizure episodes. Topiramate also can be used to prevent migraine headaches and takes some time to reach the therapeutic levels. Do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
10. Topiramate only prevents the seizures and migraine headaches from happening, by reducing the excitation and rapid firing of the nerves. But, topiramate does not fix the actual condition causing the seizures or migraine headaches. Continue taking topiramate as ordered, even if you experience relief from seizures and migraine episodes. Abrupt discontinuation on topiramate intake can result in life-threatening seizure episodes and recurrence of severe migraine headache. Discontinuing the medication should only be on your physician’s recommendation and must be slow and gradual, using tapering doses.
11. Notify your doctor of any continuing episodes of seizures, so that, your dosage on the medication could be revised.
12. Your physician could change the dose of topiramate, based on the relief obtained or side-effects developed. So, maintain compliance with follow-up physician appointments, to update on the relief from symptoms and side-effects developed. Be accommodative to the plan of dose changes, if need be, until you show an optimum response.
13. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.