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Topamax has both opioid and monoaminergic agonist actions.

Topamax has not been shown to cause histamine release. At therapeutic doses, Topamax has no effect on heart rate,
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Topamax had only slight thermoregulatory effects. Its use is thus unlikely to provoke hypothermia or to facilitate fever.

Ask your health care provider if Topamax may interact with other medicines that you take.
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In general, both enantiomers of Topamax and M1 follow a parallel time course in the body following single and multiple doses although small differences (~10%) exist in the absolute amount of each enantiomer present.
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Tell your doctor or dentist that you take Topamax before you receive any medical or dental care, emergency care, or surgery.
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Do not drive or perform other possibly unsafe tasks until you know how you react to it.Do not drink
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Topamax was evaluated in peri- and post-natal studies in rats.
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Taking more than the prescribed amount of this medication could result in seizures or decreased breathing.
Topamax may increase the seizure risk in patients taking other medications that lower the seizure threshold.
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since observed maximal placoncentrations after multiple oral doses are higher than expected based on single-dose data.
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1 Dosing may be increased to 100 mg every four to six hours, but the daily dosage should not exceed 400 mg 1 and should be limited to 250 to 300 mg .
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