What is carbamazepine? Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder. Carbamazepine may also be used for purposes not listed in this medication guide. Warnings You should not take carbamazepine if you have a history of bone marrow suppression, if you are allergic to it, or take an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline. TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects. Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling. Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Do not stop taking this medicine without asking your doctor first, even if you feel fine. If you are pregnant, do not start or stop taking carbamazepine without your doctor's advice. Before taking this medicine You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline. Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk. Tell your doctor if you have ever had: heart problems; liver or kidney disease; glaucoma; porphyria; low sodium levels; depression, mood disorder; or suicidal thoughts or actions. You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not start or stop taking seizure medication during pregnancy without your doctor's advice. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby. Tell your doctor right away if you become pregnant. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby. Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy. You should not breastfeed while you are using carbamazepine. How should I take carbamazepine? Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Take with food. Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole. The chewable tablet must be chewed before you swallow it. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures. You will need frequent medical tests. Store at room temperature away from moisture, heat, and light. Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness. What to avoid Drinking alcohol with this medicine can cause side effects, and can also increase your risk of seizures. Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Carbamazepine could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Carbamazepine side effects Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a skin rash, no matter how mild; loss of appetite, right-sided upper stomach pain, dark urine; slow, fast, or pounding heartbeats; anemia or other blood problems - fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or low levels of sodium in the body - headache, confusion, severe weakness, feeling unsteady, increased seizures. Common carbamazepine side effects may include: dizziness, loss of coordination, problems with walking; nausea, vomiting; or drowsiness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect carbamazepine? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures. Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is carbamazepine? Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder. Carbamazepine may also be used for purposes not listed in this medication guide. Warnings You should not take carbamazepine if you have a history of bone marrow suppression, if you are allergic to it, or take an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline. TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make this medicine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects. Carbamazepine may cause serious blood problems or a life-threatening skin rash or allergic reaction. Call your doctor if you have a fever, unusual weakness, bleeding, bruising, or a skin rash that causes blistering and peeling. Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Do not stop taking this medicine without asking your doctor first, even if you feel fine. If you are pregnant, do not start or stop taking carbamazepine without your doctor's advice. Before taking this medicine You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline, desipramine, doxepin, imipramine, or nortriptyline. Do not use carbamazepine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk. Tell your doctor if you have ever had: heart problems; liver or kidney disease; glaucoma; porphyria; low sodium levels; depression, mood disorder; or suicidal thoughts or actions. You may have thoughts about suicide while taking carbamazepine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not start or stop taking seizure medication during pregnancy without your doctor's advice. Carbamazepine may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby. Tell your doctor right away if you become pregnant. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of this medicine on the baby. Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy. You should not breastfeed while you are using carbamazepine. How should I take carbamazepine? Take carbamazepine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Take with food. Swallow the extended-release tablet or capsule whole and do not crush, chew, or break it. Tell your doctor if you cannot swallow a pill whole. The chewable tablet must be chewed before you swallow it. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures. You will need frequent medical tests. Store at room temperature away from moisture, heat, and light. Do not stop using carbamazepine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe drowsiness, weak or shallow breathing, and loss of consciousness. What to avoid Drinking alcohol with this medicine can cause side effects, and can also increase your risk of seizures. Grapefruit may interact with carbamazepine and lead to unwanted side effects. Avoid the use of grapefruit products. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Carbamazepine could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Carbamazepine side effects Get emergency medical help if you have signs of an allergic reaction to carbamazepine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a skin rash, no matter how mild; loss of appetite, right-sided upper stomach pain, dark urine; slow, fast, or pounding heartbeats; anemia or other blood problems - fever, chills, sore throat, mouth sores, bleeding gums, nosebleeds, pale skin, easy bruising, unusual tiredness, feeling light-headed or short of breath; or low levels of sodium in the body - headache, confusion, severe weakness, feeling unsteady, increased seizures. Common carbamazepine side effects may include: dizziness, loss of coordination, problems with walking; nausea, vomiting; or drowsiness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect carbamazepine? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Using carbamazepine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety, depression, or seizures. Many drugs can interact with carbamazepine, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is clonazepam? Clonazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain. Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children. Clonazepam is also used to treat panic disorder (including agoraphobia) in adults. Warnings Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law. Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide. Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer. Before taking this medicine You should not take clonazepam if you allergic to it or if you have: narrow-angle glaucoma; severe liver disease; or a history of allergic reaction to any benzodiazepine (including alprazolam, diazepam, lorazepam, Valium, Xanax, Versed, and others). To make sure this medicine is safe for you, tell your doctor if you have ever had: kidney or liver disease; breathing problems; depression, mood problems, or suicidal thoughts or behavior; or porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system). Some people have thoughts about suicide while taking clonazepam. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior. Tell your doctor if you are pregnant or plan to become pregnant. If you use clonazepam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks. Do not start or stop seizure medication during pregnancy without your doctor's advice. Clonazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Preventing seizures may outweigh these risks. Tell your doctor right away if you become pregnant. Ask a doctor if it is safe to breastfeed while using this medicine. Do not give this medicine to a child without medical advice. Clonazepam is not approved to treat panic disorder in anyone younger than 18 years old. How should I take clonazepam? Take clonazepam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. You will need frequent medical tests. Do not stop using clonazepam suddenly, even if you feel fine. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose. Swallow the regular tablet whole, with a full glass of water. Clonazepam doses are based on weight in children. Your child's dose needs may change if the child gains or loses weight. Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet in your mouth and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves. Your doctor will need to check your progress on a regular basis. Call your doctor if this medicine seems to stop working as well in treating your seizures or panic attacks. Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Store at room temperature away from moisture, heat, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of clonazepam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, or coma. What should I avoid while taking clonazepam? Do not drink alcohol. Dangerous side effects or death could occur. Avoid driving or hazardous activity until you know how clonazepam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Clonazepam side effects Get emergency medical help if you have signs of an allergic reaction to clonazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: new or worsening seizures; severe drowsiness; weak or shallow breathing; unusual changes in mood or behavior; confusion, paranoia, nightmares, hallucinations; thoughts of suicide or hurting yourself; unusual or involuntary eye movements. Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury. Common clonazepam side effects may include: drowsiness, dizziness; feeling tired or depressed; memory problems; or problems with walking or coordination. After you stop using clonazepam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions. Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect clonazepam? Using clonazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Other drugs may interact with clonazepam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

What is divalproex sodium? Divalproex sodium comes in different pill forms that are for different uses. Divalproex sodium tablets and capsules are used to treat seizures in people with epilepsy who are at least 10 years old. Divalproex sodium tablets are sometimes used together with other seizure medications. Divalproex sodium tablets are also used in adults to prevent migraine headaches, or to treat manic episodes related to bipolar disorder (manic depression). Divalproex sodium may also be used for purposes not listed in this medication guide. Warnings You should not use divalproex sodium if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome. Do not start or stop taking divalproex sodium during pregnancy without your doctor's advice. Divalproex sodium may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Do not use divalproex sodium to prevent migraine headaches if you are pregnant. Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by certain genetic disorders. Call your doctor at once if the person taking divalproex sodium has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Do not stop using divalproex sodium without your doctor's advice. Stopping suddenly may cause a serious, life-threatening type of seizure. Before taking this medicine You should not use divalproex sodium if you are allergic to it, or if you have: liver disease; a urea cycle disorder; or a genetic mitochondrial (MYE-toe-KON-dree-al) disorder such as Alpers' disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2 years old. Divalproex sodium can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder. Tell your doctor if you have ever had: liver problems caused by a genetic mitochondrial disorder; depression, mental illness, or suicidal thoughts or actions; or a family history of a urea cycle disorder or infant deaths with unknown cause. Some people have thoughts about suicide while taking divalproex sodium. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Using divalproex sodium during pregnancy may increase the risk of serious birth defects that can develop early in pregnancy, even before you know you are pregnant. Using this medicine during pregnancy can also affect cognitive ability (reasoning, intelligence, problem-solving) later in your child's life. However, having a seizure during pregnancy could harm both the mother and the baby. If you take divalproex sodium for seizures or manic episodes: The benefit of preventing seizures or manic episodes may outweigh any risks posed by this medicine. There may be other medications that are safer to use during pregnancy. Do not start or stop taking divalproex sodium without your doctor's advice. Do not use divalproex sodium to prevent migraine headaches if you are pregnant or you could become pregnant. If you are not pregnant, use effective birth control to prevent pregnancy while using divalproex sodium. Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with divalproex sodium and make it less effective in preventing seizures. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. How should I take divalproex sodium? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day. Swallow the capsule or tablet whole and do not crush, chew, break, or open it. If you cannot swallow a sprinkle capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away. Do not save it for later use. You may need frequent blood tests. If you need surgery, tell the surgeon ahead of time that you are using divalproex sodium. In case of emergency, wear or carry medical identification to let others know you use divalproex sodium. Do not stop using divalproex sodium suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture and heat.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking divalproex sodium? Drinking alcohol may increase certain side effects of divalproex sodium. Avoid driving or hazardous activity until you know how divalproex sodium will affect you. Your reactions could be impaired. Divalproex sodium side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have any of these other side effects: easy bruising, unusual bleeding (nose, mouth, or gums), purple or red pinpoint spots under your skin; fever, swollen glands, mouth sores; confusion, tiredness, cold feeling, vomiting, change in your mental state; severe drowsiness; or worsening seizures. Common side effects may include: nausea, vomiting, stomach pain, diarrhea, constipation; headache, back pain; dizziness, drowsiness, weakness, tremors; memory problems, mood changes, trouble sleeping; bruising or bleeding; runny nose, sore throat, cough, wheezing, trouble breathing; fever, flu symptoms; problems with walking or coordination; swelling in your hands or feet; blurred vision, double vision, unusual eye movements; ringing in your ears; rash, hair loss; or changes in weight or appetite. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect divalproex sodium? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Many drugs can affect divalproex sodium. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is levetiracetam? Levetiracetam is used to treat certain types of seizures in people with epilepsy, including partial onset seizures, myoclonic seizures, and tonic-clonic seizures. When used for partial onset seizures: Extended-release (XR) levetiracetam is for adults and children at least 12 years old. Spritam is for children at least 4 years old who weigh at least 44 pounds (20 kilograms). Roweepra and Keppra may be used in children as young as 1 month old. Levetiracetam is also used with other seizure medications to treat tonic-clonic seizures in people who are at least 6 years old, and myoclonic seizures in people at least 12 years old. Levetiracetam injection is for use only in people who are least 16 years old. Levetiracetam may also be used for purposes not listed in this medication guide. Warnings Some people have thoughts about suicide while taking levetiracetam. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Seizures may increase if you stop using levetiracetam suddenly. Before taking this medicine You should not use levetiracetam if you are allergic to it. Tell your doctor if you have ever had: kidney disease (or if you are on dialysis); depression or other mood problems; mental illness or psychosis; or suicidal thoughts or actions. Do not give levetiracetam to a child without medical advice. Different brands of this medicine are for use only in children of certain ages. Some people have thoughts about suicide while taking levetiracetam. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not start or stop seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant. Your dose needs may be different during pregnancy. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of levetiracetam on the baby. Ask a doctor if it is safe to breastfeed while using this medicine. How should I take levetiracetam? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Levetiracetam oral is taken by mouth at the same time each day, with or without food. Levetiracetam injection is given in a vein if you are unable to take the medicine by mouth. Your dose needs may change if you switch to a different brand, strength, or form of this medicine. A child's dose needs may change if the child gains or loses weight. Avoid medication errors by using only the brand, form, and strength your doctor prescribes. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon). Swallow the extended-release tablet whole and do not crush, chew, or break it. Do not swallow or chew a Spritam dispersible tablet for oral suspension. Place the tablet on your tongue and take a sip of liquid. Do not swallow until the tablet has completely dissolved on your tongue. Your kidney function may need to be tested. Use all seizure medications as directed. Do not change your dose or stop using a medicine without your doctor's advice. Seizures may increase if you stop using levetiracetam suddenly.. Ask your doctor before stopping the medicine. Wear a medical alert tag or carry an ID card to let others know you have seizures. Store at room temperature away from moisture, heat, and light.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. Get your prescription refilled before you run out of medicine completely. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include extreme drowsiness, agitation, aggression, shallow breathing, weakness, or fainting. What should I avoid while taking levetiracetam? Avoid driving or hazardous activity until you know how levetiracetam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Levetiracetam side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: unusual changes in mood or behavior (unusual risk-taking behavior, being irritable or talkative); confusion, hallucinations, extreme drowsiness, feeling very weak or tired; loss of balance or coordination, problems with walking or movement; a skin rash, no matter how mild; easy bruising, unusual bleeding; or fever, chills, weakness, or other signs of infection. Common side effects may include: dizziness, drowsiness, tiredness, weakness; feeling aggressive or irritable; loss of appetite; stuffy nose; or infection. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is levetiracetam? Levetiracetam is used to treat certain types of seizures in people with epilepsy, including partial onset seizures, myoclonic seizures, and tonic-clonic seizures. When used for partial onset seizures: Extended-release (XR) levetiracetam is for adults and children at least 12 years old. Spritam is for children at least 4 years old who weigh at least 44 pounds (20 kilograms). Roweepra and Keppra may be used in children as young as 1 month old. Levetiracetam is also used with other seizure medications to treat tonic-clonic seizures in people who are at least 6 years old, and myoclonic seizures in people at least 12 years old. Levetiracetam injection is for use only in people who are least 16 years old. Levetiracetam may also be used for purposes not listed in this medication guide. Warnings Some people have thoughts about suicide while taking levetiracetam. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Seizures may increase if you stop using levetiracetam suddenly. Before taking this medicine You should not use levetiracetam if you are allergic to it. Tell your doctor if you have ever had: kidney disease (or if you are on dialysis); depression or other mood problems; mental illness or psychosis; or suicidal thoughts or actions. Do not give levetiracetam to a child without medical advice. Different brands of this medicine are for use only in children of certain ages. Some people have thoughts about suicide while taking levetiracetam. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not start or stop seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant. Your dose needs may be different during pregnancy. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of levetiracetam on the baby. Ask a doctor if it is safe to breastfeed while using this medicine. How should I take levetiracetam? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Levetiracetam oral is taken by mouth at the same time each day, with or without food. Levetiracetam injection is given in a vein if you are unable to take the medicine by mouth. Your dose needs may change if you switch to a different brand, strength, or form of this medicine. A child's dose needs may change if the child gains or loses weight. Avoid medication errors by using only the brand, form, and strength your doctor prescribes. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions. Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon). Swallow the extended-release tablet whole and do not crush, chew, or break it. Do not swallow or chew a Spritam dispersible tablet for oral suspension. Place the tablet on your tongue and take a sip of liquid. Do not swallow until the tablet has completely dissolved on your tongue. Your kidney function may need to be tested. Use all seizure medications as directed. Do not change your dose or stop using a medicine without your doctor's advice. Seizures may increase if you stop using levetiracetam suddenly.. Ask your doctor before stopping the medicine. Wear a medical alert tag or carry an ID card to let others know you have seizures. Store at room temperature away from moisture, heat, and light.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. Get your prescription refilled before you run out of medicine completely. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include extreme drowsiness, agitation, aggression, shallow breathing, weakness, or fainting. What should I avoid while taking levetiracetam? Avoid driving or hazardous activity until you know how levetiracetam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries. Levetiracetam side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel agitated, hostile, irritable, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: unusual changes in mood or behavior (unusual risk-taking behavior, being irritable or talkative); confusion, hallucinations, extreme drowsiness, feeling very weak or tired; loss of balance or coordination, problems with walking or movement; a skin rash, no matter how mild; easy bruising, unusual bleeding; or fever, chills, weakness, or other signs of infection. Common side effects may include: dizziness, drowsiness, tiredness, weakness; feeling aggressive or irritable; loss of appetite; stuffy nose; or infection. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect levetiracetam? Other drugs may affect levetiracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

What is Phenytoin Sodium, Prompt? Phenytoin Sodium, Prompt injection is an anticonvulsant medication that is used to treat a prolonged seizure (status epilepticus). Phenytoin Sodium, Prompt injection is also used to prevent seizures during a surgery. Phenytoin Sodium, Prompt injection may also be used for purposes not listed in this medication guide. Warnings A Phenytoin Sodium, Prompt injection may cause life-threatening heart problems. Phenytoin Sodium, Prompt Sodium, Prompt is usually given by injection only if you are unable to take the medicine by mouth. If possible before you receive a Phenytoin Sodium, Prompt injection, tell your caregivers if you have ever had serious heart problems, or slow heartbeats that have caused you to faint. Your heart rate, breathing, blood pressure, and other vital signs will be watched closely. Tell your caregiver if you feel weak, light-headed, or short of breath during or after an injection. Before taking this medicine If possible before you receive a Phenytoin Sodium, Prompt injection, tell your caregivers if you have ever had: a heart condition called 2nd or 3rd degree "AV block"; slow heartbeats that have caused you to faint; liver problems caused by Phenytoin Sodium, Prompt Sodium, Prompt; or if you currently take delavirdine (Rescriptor). Tell your doctor if you have ever had: liver or kidney disease; diabetes; porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or if you are of Asian ancestry (you may need a special blood test to determine your risk for having a skin reaction to Phenytoin Sodium, Prompt Sodium, Prompt). Tell your doctor if you are pregnant. Phenytoin Sodium, Prompt may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby. If you have received a Phenytoin Sodium, Prompt injection during pregnancy, be sure to tell the doctor who delivers your baby about your Phenytoin Sodium, Prompt use. Both you and the baby may need to receive medications to prevent excessive bleeding during delivery and just after birth. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of Phenytoin Sodium, Prompt on the baby. Phenytoin Sodium, Prompt can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy. It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk. In an emergency, you may not be able to tell caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you received this medicine. How is Phenytoin Sodium, Prompt given? Phenytoin Sodium, Prompt is injected into a muscle, or given as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth. Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Phenytoin Sodium, Prompt is injected. While receiving Phenytoin Sodium, Prompt, you may need frequent blood tests. You may also need a blood test when switching from the injection form to the oral form of Phenytoin Sodium, Prompt. You should not stop using Phenytoin Sodium, Prompt suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. Phenytoin Sodium, Prompt can cause swelling in your gums. Pay special attention to your dental hygiene while receiving Phenytoin Sodium, Prompt Sodium, Prompt. Brush and floss your teeth regularly. What happens if I miss a dose? Because you will receive Phenytoin Sodium, Prompt Sodium, Prompts in a clinical setting, you are not likely to miss a dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Phenytoin Sodium, Prompt can be fatal. Overdose symptoms may include twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. What should I avoid while taking Phenytoin Sodium, Prompt? Avoid driving or hazardous activity until you know how Phenytoin Sodium, Prompt Sodium, Prompt will affect you. Your reactions could be impaired. Avoid drinking alcohol while you are taking Phenytoin Sodium, Prompt. Alcohol use can increase your blood levels of Phenytoin Sodium, Prompt and may increase side effects. Daily alcohol use can decrease your blood levels of Phenytoin Sodium, Prompt, which can increase your risk of seizures. Ask a doctor or pharmacist before using over-the-counter medicines such as cimetidine, omeprazole, St. John's wort, or vitamins and mineral supplements that contain folic acid. Phenytoin Sodium, Prompt side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. A Phenytoin Sodium, Prompt injection may cause life-threatening heart problems. Tell your caregiver if you feel weak, light-headed, or short of breath during or after an injection. Call your doctor at once if you have: a light-headed feeling, like you might pass out; confusion, unusual thoughts or behavior; fever, chills, sore throat, swollen glands; red or swollen gums, mouth sores; easy bruising, unusual bleeding; pain, swelling, bruising, or other irritation where the injection was given; purple discoloration of your skin around the IV needle, or spreading away from where the medicine was injected (may occur several days after an injection); increased thirst, increased urination; or liver problems--loss of appetite, upper stomach pain, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Common side effects may include: drowsiness, confusion; slurred speech; abnormal eye movement; or problems with balance or muscle movement. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect Phenytoin Sodium, Prompt? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Many drugs can interact with Phenytoin Sodium, Prompt. Not all possible interactions are listed here. TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE, and any you start or stop using during treatment with Phenytoin Sodium, Prompt. This includes prescription and over-the-counter medicines, vitamins, and herbal products.

What is primidone? Primidone is an anticonvulsant medicine that is used to control seizures. Primidone may also be used for purposes not listed in this medication guide. Warnings Some people have thoughts about suicide while taking primidone. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Do not stop using primidone suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Before taking this medicine You should not use primidone if you are allergic to primidone or phenobarbital, or if you have: porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system). Tell your doctor if you have ever had: depression; a mood disorder; or suicidal thoughts or actions. Some people have thoughts about suicide while taking primidone. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not start or stop taking seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of primidone on the baby. Be sure to tell the doctor who delivers your baby about your primidone use. Both you and the baby may need to receive medications to prevent excessive bleeding during delivery and just after birth. Stop breast-feeding if you notice unusual drowsiness in the nursing baby. Talk with your doctor about how best to feed your baby while taking primidone. How should I take primidone? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. If you are switching to primidone from another seizure medication, you may need to start taking primidone only at bedtime. Follow your doctor's instructions. Do not stop using primidone suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. It may take several weeks before you receive the full benefit of taking primidone. Your doctor will determine how long to treat you with this medicine. If you use this medicine long-term, you may need frequent medical tests. Store primidone at room temperature away from moisture, light, and heat. In case of emergency, wear or carry medical identification to let others know you take seizure medication.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking primidone? Avoid driving or hazardous activity until you know how primidone will affect you. Your reactions could be impaired. Drinking alcohol with this medicine can increase side effects. Primidone side effects Get emergency medical help if you have signs of an allergic reaction: hives, mouth sores, skin rash with blistering and peeling; difficult breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: unusual thoughts or behavior; loss of balance or coordination; fever, chills, sore throat; easy bruising or bleeding; or pale skin, unusual tiredness. Common side effects may include: dizziness, drowsiness, spinning sensation; problems with balance or muscle movement; nausea, vomiting, loss of appetite; feeling tired or irritable; blurred vision; rash; or impotence, sexual problems. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect primidone? Using primidone with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Other drugs may affect primidone, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is topiramate? Topiramate is a seizure medicine, also called an anticonvulsant. Topiramate is used to treat certain types of seizures in adults and children who are at least 2 years old. Trokendi XR is for use in adults and children who are at least 6 years old. Some brands of topiramate are also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. These medicines will only prevent migraine headaches or reduce the number of attacks, but will not treat a headache that has already begun. Topiramate may also be used for purposes not listed in this medication guide. Warnings Topiramate may cause vision problems that can be permanent if not treated quickly. Call your doctor right away if you have a sudden decrease in vision. Topiramate can increase body temperature and decrease sweating, which may lead to life-threatening dehydration. Tell your doctor if you have decreased sweating, high fever, and hot dry skin. Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Before taking this medicine You should not use topiramate if you are allergic to it. Do not take Trokendi XR within 6 hours before or 6 hours after drinking alcohol. Tell your doctor if you are sick with diarrhea, or if you have ever had: glaucoma or other eye problems; metabolic acidosis (high levels of acid in your blood); kidney disease, kidney stones, or dialysis; lung disease, breathing problems; mood problems, depression, or suicidal thoughts or actions; liver disease; a growth disorder; or soft or brittle bones (osteoporosis, osteomalacia). Topiramate can increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children or harm to an unborn baby. You may need blood tests to make sure you do not have metabolic acidosis, especially if you are pregnant. Some people have thoughts about suicide while taking an anticonvulsant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Taking topiramate during pregnancy may increase the risk of cleft lip and/or cleft palate, a birth defect that can develop early in pregnancy even before you know you are pregnant. However, having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant. If you take topiramate during pregnancy: The benefit of preventing seizures may outweigh any risks posed by topiramate. There may be other medications that are safer to use. Do not start or stop taking topiramate without your doctor's advice. If you are not pregnant or planning to become pregnant, use effective birth control to prevent pregnancy while taking topiramate. Topiramate can make birth control pills less effective. Ask your doctor about other birth control options such as an injection, implant, skin patch, vaginal ring, condom, diaphragm, cervical cap, or contraceptive sponge. It may not be safe to breastfeed a baby while you are using this medicine. Ask your doctor about any risks. How should I take topiramate? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Topiramate can be taken with or without food. Swallow the tablet whole and do not crush, chew, or break it. The Trokendi XR extended-release capsule must be swallowed whole. Do not break or open. Measure liquid medicine with the supplied measuring device (not a kitchen spoon). If you cannot swallow a Qudexy XR or Topamax Sprinkle Capsule whole, open it and sprinkle the medicine into a spoonful of applesauce or other soft food. Swallow the mixture right away without chewing. Do not save it for later use. Carefully follow the swallowing instructions for your medicine. Topiramate doses are sometimes based on weight in children. Your child's dose needs may change if the child gains or loses weight. Drink plenty of liquids while you are taking topiramate, to prevent kidney stones or an electrolyte imbalance. You will need frequent medical tests. If you need surgery, tell the surgeon ahead of time that you are using topiramate. Any medical care provider who treats you should know that you take seizure medication. Do not stop using topiramate suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. Call your doctor if your seizures get worse or you have them more often while taking topiramate. Store at cool room temperature away from moisture, light, and high heat.   What happens if I miss a dose? Take the medicine as soon as you can. Do not take two doses at one time. Skip a missed Topamax dose if your next dose is due in less than 6 hours. Call your doctor if you have missed more than one dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of topiramate can be fatal. Overdose can cause drowsiness, agitation, depression, double vision, thinking problems, problems with speech or coordination, fainting, and seizure (convulsions). What should I avoid while taking topiramate? Do not drink alcohol. Dangerous side effects or increased seizures may occur. Avoid becoming overheated or dehydrated in hot weather. Topiramate can increase body temperature and decrease sweating, leading to life-threatening dehydration (especially in children). Avoid the use of a ketogenic or "ketosis" diet (high in fat, low in carbohydrates) while you are taking topiramate. Topiramate may cause blurred vision or impair your thinking or reactions. Avoid driving or operating machinery until you know how topiramate will affect you. Also avoid activities that could be dangerous if you have an unexpected seizure, such as swimming or climbing in high places. Topiramate side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Report any new or worsening mood symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a skin rash, no matter how mild; vision problems, blurred vision, eye pain or redness, sudden vision loss (can be permanent if not treated quickly); confusion, problems with thinking or memory, trouble concentrating, problems with speech; dehydration symptoms--decreased sweating, high fever, hot and dry skin; signs of a kidney stone--severe pain in your side or lower back, painful or difficult urination; signs of too much acid in your blood--irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or signs of too much ammonia in your blood--vomiting, unexplained weakness, feeling like you might pass out. Common side effects may include: dizziness, drowsiness, tiredness, slow reactions; problems with speech or memory, abnormal vision; numbness or tingling in your arms and legs, decreased sensation (especially in the skin); changes in your sense of taste, feeling nervous; nausea, diarrhea, stomach pain, loss of appetite; fever, weight loss; or cold symptoms such as stuffy nose, sneezing, sore throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect topiramate? Using topiramate with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or depression. Tell your doctor about all your other medicines, especially: zonisamide; birth control pills; divalproex, valproic acid; or other glaucoma medications, including eye drops. This list is not complete. Other drugs may affect topiramate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is topiramate? Topiramate is a seizure medicine, also called an anticonvulsant. Topiramate is used to treat certain types of seizures in adults and children who are at least 2 years old. Trokendi XR is for use in adults and children who are at least 6 years old. Some brands of topiramate are also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. These medicines will only prevent migraine headaches or reduce the number of attacks, but will not treat a headache that has already begun. Topiramate may also be used for purposes not listed in this medication guide. Warnings Topiramate may cause vision problems that can be permanent if not treated quickly. Call your doctor right away if you have a sudden decrease in vision. Topiramate can increase body temperature and decrease sweating, which may lead to life-threatening dehydration. Tell your doctor if you have decreased sweating, high fever, and hot dry skin. Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Before taking this medicine You should not use topiramate if you are allergic to it. Do not take Trokendi XR within 6 hours before or 6 hours after drinking alcohol. Tell your doctor if you are sick with diarrhea, or if you have ever had: glaucoma or other eye problems; metabolic acidosis (high levels of acid in your blood); kidney disease, kidney stones, or dialysis; lung disease, breathing problems; mood problems, depression, or suicidal thoughts or actions; liver disease; a growth disorder; or soft or brittle bones (osteoporosis, osteomalacia). Topiramate can increase the level of acid in your blood (metabolic acidosis). This can weaken your bones, cause kidney stones, or cause growth problems in children or harm to an unborn baby. You may need blood tests to make sure you do not have metabolic acidosis, especially if you are pregnant. Some people have thoughts about suicide while taking an anticonvulsant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Taking topiramate during pregnancy may increase the risk of cleft lip and/or cleft palate, a birth defect that can develop early in pregnancy even before you know you are pregnant. However, having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant. If you take topiramate during pregnancy: The benefit of preventing seizures may outweigh any risks posed by topiramate. There may be other medications that are safer to use. Do not start or stop taking topiramate without your doctor's advice. If you are not pregnant or planning to become pregnant, use effective birth control to prevent pregnancy while taking topiramate. Topiramate can make birth control pills less effective. Ask your doctor about other birth control options such as an injection, implant, skin patch, vaginal ring, condom, diaphragm, cervical cap, or contraceptive sponge. It may not be safe to breastfeed a baby while you are using this medicine. Ask your doctor about any risks. How should I take topiramate? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Topiramate can be taken with or without food. Swallow the tablet whole and do not crush, chew, or break it. The Trokendi XR extended-release capsule must be swallowed whole. Do not break or open. Measure liquid medicine with the supplied measuring device (not a kitchen spoon). If you cannot swallow a Qudexy XR or Topamax Sprinkle Capsule whole, open it and sprinkle the medicine into a spoonful of applesauce or other soft food. Swallow the mixture right away without chewing. Do not save it for later use. Carefully follow the swallowing instructions for your medicine. Topiramate doses are sometimes based on weight in children. Your child's dose needs may change if the child gains or loses weight. Drink plenty of liquids while you are taking topiramate, to prevent kidney stones or an electrolyte imbalance. You will need frequent medical tests. If you need surgery, tell the surgeon ahead of time that you are using topiramate. Any medical care provider who treats you should know that you take seizure medication. Do not stop using topiramate suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. Call your doctor if your seizures get worse or you have them more often while taking topiramate. Store at cool room temperature away from moisture, light, and high heat.   What happens if I miss a dose? Take the medicine as soon as you can. Do not take two doses at one time. Skip a missed Topamax dose if your next dose is due in less than 6 hours. Call your doctor if you have missed more than one dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of topiramate can be fatal. Overdose can cause drowsiness, agitation, depression, double vision, thinking problems, problems with speech or coordination, fainting, and seizure (convulsions). What should I avoid while taking topiramate? Do not drink alcohol. Dangerous side effects or increased seizures may occur. Avoid becoming overheated or dehydrated in hot weather. Topiramate can increase body temperature and decrease sweating, leading to life-threatening dehydration (especially in children). Avoid the use of a ketogenic or "ketosis" diet (high in fat, low in carbohydrates) while you are taking topiramate. Topiramate may cause blurred vision or impair your thinking or reactions. Avoid driving or operating machinery until you know how topiramate will affect you. Also avoid activities that could be dangerous if you have an unexpected seizure, such as swimming or climbing in high places. Topiramate side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Report any new or worsening mood symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a skin rash, no matter how mild; vision problems, blurred vision, eye pain or redness, sudden vision loss (can be permanent if not treated quickly); confusion, problems with thinking or memory, trouble concentrating, problems with speech; dehydration symptoms--decreased sweating, high fever, hot and dry skin; signs of a kidney stone--severe pain in your side or lower back, painful or difficult urination; signs of too much acid in your blood--irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or signs of too much ammonia in your blood--vomiting, unexplained weakness, feeling like you might pass out. Common side effects may include: dizziness, drowsiness, tiredness, slow reactions; problems with speech or memory, abnormal vision; numbness or tingling in your arms and legs, decreased sensation (especially in the skin); changes in your sense of taste, feeling nervous; nausea, diarrhea, stomach pain, loss of appetite; fever, weight loss; or cold symptoms such as stuffy nose, sneezing, sore throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect topiramate? Using topiramate with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or depression. Tell your doctor about all your other medicines, especially: zonisamide; birth control pills; divalproex, valproic acid; or other glaucoma medications, including eye drops. This list is not complete. Other drugs may affect topiramate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is valproic acid? Valproic acid is used to treat various types of seizure disorders. Valproic acid is sometimes used together with other seizure medications. Valproic acid is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches. Valproic acid may also be used for purposes not listed in this medication guide. Warnings Valproic acid can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by certain genetic disorders. You should not use valproic acid if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome. Do not start or stop taking valproic acid during pregnancy without your doctor's advice. This medicine may harm an unborn baby or cause birth defects, but having a seizure during pregnancy could harm both mother and baby. Do not use valproic acid to prevent migraine headaches if you are pregnant. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Do not stop using valproic acid without your doctor's advice. Stopping suddenly may cause a serious, life-threatening type of seizure. Before taking this medicine You should not use valproic acid if you are allergic to it, or if you have: liver disease; a urea cycle disorder; or a genetic mitochondrial (MYE-toe-KON-dree-al) disorder such as Alpers' disease or Alpers-Huttenlocher syndrome, especially in a child younger than 2 years old. Valproic acid can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by a genetic mitochondrial disorder. Tell your doctor if you have ever had: liver problems caused by a genetic mitochondrial disorder; depression, mental illness, or suicidal thoughts or actions; a family history of a urea cycle disorder or infant deaths with unknown cause; or HIV or CMV (cytomegalovirus) infection. Some young people have thoughts about suicide when first taking valproic acid. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Using valproic acid during pregnancy may increase the risk of serious birth defects that can develop early in pregnancy, even before you know you are pregnant. Using this medicine during pregnancy can also affect cognitive ability (reasoning, intelligence, problem-solving) later in your child's life. However, having a seizure during pregnancy could harm both the mother and the baby. If you take valproic acid for seizures or manic episodes: The benefit of preventing these conditions may outweigh any risks posed by this medicine. There may be other medications that are safer to use during pregnancy. Do not start or stop taking valproic acid without your doctor's advice. Do not use valproic acid to prevent migraine headaches if you are pregnant or you could become pregnant. If you are not pregnant, use effective birth control to prevent pregnancy while using valproic acid. Tell your doctor if you start or stop using hormonal contraception that contains estrogen (birth control pills, injections, implants, skin patches, and vaginal rings). Estrogen can interact with valproic acid and make it less effective in preventing seizures. It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk. How should I take valproic acid? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Valproic acid oral is taken by mouth. Valproic acid injection is given as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth. Drink plenty of water while you are taking this medication. Your dose may need to be changed if you do not get enough fluids each day. Take with food if valproic acid upsets your stomach. Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Swallow the capsule whole and do not crush, chew, break, or open it. Tell your doctor if you notice a capsule shell in your stool that was not absorbed or melted in the body. Your blood levels of valproic acid may need to be checked. You may need frequent blood tests. If you need surgery, tell the surgeon ahead of time that you are using valproic acid. In case of emergency, wear or carry medical identification to let others know you use valproic acid. Do not stop using valproic acid suddenly, even if you feel fine. Stopping suddenly may cause a serious, life-threatening type of seizure. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture and heat.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking valproic acid? Drinking alcohol may increase certain side effects of valproic acid. Avoid driving or hazardous activity until you know how valproic acid will affect you. Your reactions could be impaired. Valproic acid side effects Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. Call your doctor at once if the person taking this medicine has signs of liver or pancreas problems, such as: loss of appetite, upper stomach pain (that may spread to your back), ongoing nausea or vomiting, dark urine, swelling in the face, or jaundice (yellowing of the skin or eyes). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself. Call your doctor at once if you have any of these other side effects: confusion, tiredness, cold feeling, vomiting, change in your mental state; easy bruising, unusual bleeding (nose, mouth, or gums), purple or red pinpoint spots under your skin; severe drowsiness; or worsening seizures. Severe drowsiness may be more likely in older adults. Common side effects may include: nausea, vomiting, stomach pain, diarrhea; dizziness, drowsiness, weakness; headache; tremors, problems with walking or coordination; blurred vision, double vision; hair loss; or changes in appetite, weight gain. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect valproic acid? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Many drugs can affect valproic acid. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is Zonegran? Zonegran (zonisamide) is a sulfa drug with anti-convulsant effects. Zonegran is a prescription medicine used together with other medicines to treat partial partial seizures in adults with epilepsy. It is not known if Zonegran is safe or effective in children under 16 years of age. Warnings You should not use Zonegran if you are allergic to zonisamide, or to other sulfa drugs such as sulfamethoxazole (Gantanol), sulfisoxazole (Gantrisin), or sulfamethoxazole-trimethoprim (Bactrim, Septra, Sulfatrim, SMX-TMP, and others). A sulfa drug allergic reaction can be fatal. Taking Zonegran can cause permanent vision loss. Tell your doctor right away if you have any eye pain or redness or any changes in your vision. Some people have thoughts about suicide while taking zonisamide. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Zonegran may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using this medicine without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Zonegran suddenly. You may need to use less and less before you stop the medication completely. If you need surgery, tell the surgeon ahead of time that you are using Zonegran. You may need to stop using the medicine for a short time. Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Before taking this medicine You may not be able to take Zonegran if you have ever had a severe allergic to a sulfa drug. To make sure Zonegran is safe for you, tell your doctor if you have ever had: liver disease; kidney disease; high levels of ammonia; stomach flu or illness causing diarrhea; a growth disorder; a bone disorder that causes soft or weak bones or low bone mineral density; depression, or suicidal thoughts or actions; if you have ever had metabolic acidosis (too much acid in your blood); or if you have been on a ketogenic diet (high-fat, high-protein, low-carb). Some people have thoughts about suicide while taking Zonegran. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Zonisamide may harm an unborn baby. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of zonisamide on the baby. You should not breastfeed while using Zonegran. Zonegran is not approved for use by anyone younger than 16 years old. How should I take Zonegran? Take Zonegran exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Zonegran can be taken with or without food. Swallow the capsule whole and do not crush, chew, break, or open it. While using Zonegran, you may need frequent blood tests. Do not stop using Zonegran suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose. Do not share this medicine with another person, even if they have the same symptoms you have. Store at room temperature away from moisture, heat, and light. Dosing information Usual Adult Dose for Seizures: 16 years of age and older: -Initial dose: 100 mg orally once a day -Titration: After 2 weeks at 100 mg/day, the dose may be increased to 200 mg/day as either a single or divided dose (100 mg orally 2 times a day) for at least 2 weeks; it can then be increased to 300 mg/day, then 400 mg/day either as a single daily dose or divided into 2 daily doses, with the dose stable for at least 2 weeks to achieve steady state at each level -Maintenance dose: 400 mg/day -Maximum dose: 600 mg/day Comments: -This drug may be taken with or without food. -Capsules should be swallowed whole. -Because of the long half-life of this drug, up to 2 weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment. -The prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of this drug at steady state (noting that many of the side effects are more frequent at doses of 300 mg per day and above). Although there is some evidence of greater response at doses above 100 to 200 mg/day, the increase appears small and formal dose response studies have not been conducted. Use: As adjunctive therapy in the treatment of partial seizures Usual Pediatric Dose for Seizures: Less than 16 years of age: Not recommended 16 years of age and older: See adult dosing   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include slow heart rate, feeling light-headed, fainting, and slow or shallow breathing. What to avoid Avoid driving or hazardous activity until you know how Zonegran will affect you. Your reactions could be impaired. Drinking alcohol with this medicine can cause side effects. Zonegran side effects Get emergency medical help if you have signs of an allergic reaction to Zonegran: any form of skin rash, hives; fever, swollen glands, feeling weak or tired, severe muscle pain, unusual bruising or bleeding; yellowing of your skin or eyes; difficult breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: eye pain or redness or any changes in your vision; decreased sweating, feeling very hot; signs of metabolic acidosis - confusion, vomiting, lack of energy, irregular heartbeats; symptoms of a blood cell disorder - fever, chills, body aches, flu symptoms, sores in your mouth and throat; symptoms of a kidney stone - severe pain in your stomach or lower back, blood in your urine; increased or worsening seizures; the first sign of any skin rash, no matter how mild; or severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Common Zonegran side effects may include: drowsiness, dizziness; problems with memory or concentration; feeling agitated or irritable; loss of coordination, trouble walking; or loss of appetite. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect Zonegran? Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking Zonegran with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or depression. Other drugs may interact with zonisamide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.