Migraine Prevention - Generic Topamax Approved

Patient Expert

For all of you who are using Topamax for Migraine and headache prevention, there's good news. Generic topiramate has been approved by the FDA and is starting to show up in pharmacies.

This will mean lower prices and, hopefully, lower insurance copayments. The average price of 60 Topamax tablets, 100mg is $434. The average price for 60 generic topiramate tablets, 100mg is $50.

At this point, generic topiramate is FDA approved only to prevent seizures, but doctors will undoubtedly be prescribing generic topiramate off-label for the same uses as they've been prescribing Topamax.

Some insurance companies have been known to deny coverage of medications not FDA approved for the condition for which it was prescribed. Call me cynical, but given the difference in cost, I don't anticipate this being an issue with topiramate.

Topiramate tablets in several different strengths have been approved to be marketed by the following companies:

  • Roxane Laboratories Inc.
  • Par Pharmaceuticals Inc.
  • Mylan Pharmaceuticals Inc.
  • Barr Laboratories Inc.
  • TEVA Pharmaceuticals USA
  • Ranbaxy Laboratories Ltd.
  • CIPLA Ltd.
  • Glenmark Generics Ltd.
  • Cobalt Laboratories
  • Apotex Inc.
  • Zydus Pharmaceuticals USA
  • Aurobindo Pharma Ltd.
  • Torrent Pharmaceuticals Ltd.
  • Invagen Pharmaceuticals Inc.
  • Unichem Laboratories Ltd.
  • Sun Pharmaceuticals Ltd.
  • Pliva Hrvatska

The labeling for Topamax and generic topiramate contains an important safety warning about metabolic acidosis, a condition associated with excessive acid in the blood, which can cause symptoms such as tiredness, loss of appetite, irregular heartbeat, and impaired consciousness. Health care professionals should perform a blood test to monitor the level of a patient's serum bicarbonate.

The use of topiramate has been associated with serious eye problems, such as a sudden decrease in vision and a blockage of fluid in the eye causing increased pressure in the eye and possible glaucoma. Patients taking topiramate should contact their health care professional immediately if they have a loss in vision or experience eye pain. These problems can lead to blindness if not treated right away.

Topiramate works quite well as a Migraine and headache preventive for some people. It is, howevr, what I call a very "serious" medication. Some of it's potential side effects are very serious and potentially permanent. Anyone taking topiramate should be aware of the potential side effects and that the dosage should be tapered up slowly. Also, topiramate should NOT be abruptly discontinued.

My personal opinion is that topiramate should not be taken by children who are too young to report side effects if there is any other option.

You can find more information about topiramate below:


FDA News Release. "FDA Approves Generic Topamax to Prevent Seizures." FDA. April 1, 2009.