Topamax (topiramate) medication for migraine prevention

Topamax can make managing migraines simple and convenient. Take the first step towards preventing migraines with a board-certified doctor online. Book an appointment, get a Topamax prescription, and pick it up from your local pharmacy as soon as today.*

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Prevents cluster headaches and migraines

May also aid in weight loss

Effective seizure control

*Prescriptions are provided at the doctor’s discretion. Learn more about our controlled substances policy and how you can save up to 80% with our prescription discount card.

How does Topamax work, and what does it treat?

Topamax, or topiramate, is FDA-approved to prevent migraines and treat epilepsy. This medication works in many different pathways in the brain.

Trials showed that patients taking Topamax reduced the frequency of their migraines by over twice as much as those taking a placebo. Topamax has several other uses as well.

  • Migraine prevention & cluster headaches

    This medication is FDA-approved to prevent headaches and decrease the frequency of migraines, although it cannot help manage migraines once they've started. Topiramate may also be prescribed to prevent episodic and chronic cluster .

    Other medications our doctors may suggest for migraines and headaches include:

  • Epilepsy

    Topamax can be used with other medications to treat certain types of seizures, such as partial-onset seizures, primary generalized tonic-clonic seizures, and Lenox-Gastaut syndrome. For an indication of epilepsy or seizures, this medication is typically started and managed by board-certified neurologists. While PlushCare physicians do not usually start patients on this medication for the treatment of seizures, we can help provide emergency refills of Topamax for patients who need it for seizure control and are unable to get ahold of their neurologist.*

  • Weight loss

    Topamax may be prescribed off-label to help people with obesity . Other medications our doctors prescribe for weight loss include:

    Topamax promotes weight loss by reducing your appetite. As a result, you may not see weight loss results for a few weeks or months.

  • Bipolar disorder

    Topiramate may also be prescribed off-label as an adjunct therapy for . This is typically managed with the help of a specialist such as a psychiatrist.* This drug works in the brain to help manage manic and depressive episodes.  Other bipolar medications our doctors may prescribe include:

    *Please note that PlushCare does not have psychiatrists or neurologists at this time. However, our physicians can help patients with mental health conditions and refill medications for bipolar disorder or epilepsy following a qualifying evaluation.

What are the side effects of Topamax?

Common Topamax side effects include:

  • Nausea, diarrhea, and

  • Dizziness, drowsiness, and trouble concentrating

  • Numbness or tingling in the arms or legs

Less common side effects that may be more severe include:

  • Skin reactions, no matter how mild

  • Vision problems, such as blurred vision

  • Signs of kidney stones

  • Symptoms of dehydration

  • Allergic reaction

Drinking alcohol with Topamax can lead to serious side effects like dehydration. Topiramate can also elevate body temperature and decrease sweating, leading to life-threatening dehydration, especially in children.

How to take Topamax

Your doctor will give you instructions on how to take Topamax. It is usually taken once or twice daily, with or without food. The dose usually ranges from 25 mg to 400 mg. For weight loss, the dose may start at 25–50 mg and be taken once daily. Don't stop taking Topamax suddenly, even if your symptoms improve, as this may cause seizures.

Topamax typically stays in your system between four and six days after your last dose. If you take too much Topamax, seek immediate medical attention or call your local poison control center.

Drugs that interact with Topamax include:

  • Birth control pills (oral contraceptives)

  • Divalproex or valproic acid

  • Other medications for glaucoma, including eyedrops

  • Zonisamide

Topamax FAQs

  • How much does Topamax cost?

    Depending on your pharmacy, brand-name Topamax can cost around $424 for sixty 25 mg tablets without insurance. However, generic brands, such as topiramate, which is the active ingredient in Topamax, are often more affordable. You can also find the lowest price at nearby pharmacies and save on prescriptions as a PlushCare member.

  • Is topiramate a high-risk medication?

    No, Topamax is not a high-risk medication. Compared to other medications and antiepileptic drugs, it generally has a mild side effect profile. Speak to one of our doctors to find out if topiramate is right for you.

  • How does Topamax compare with other medications for migraines?

    Topamax has been shown to be clinically effective for migraine treatment. Trials have shown that Topamax reduced migraine frequency over twice as much in patients taking it compared to those who took a placebo. However, the best migraine medication for you depends on several factors, including your medical history and any other medications you may take. After an online evaluation, our doctors can recommend the best migraine medication for you.

How to get Topamax prescribed

Step 1: Book an appointment

Step 1

Book an appointment to get Topamax medication

Book a same-day appointment from anywhere.

Step 2

Talk to your physician regarding a Topamax prescription.

Talk to a doctor about your symptoms and medical history on your smartphone or computer.

Step 3

Pick up your Topamax prescription.

We can send prescriptions to any local pharmacy. Prescriptions are provided at the doctor’s discretion.

Topamax prescription pricing details

How pricing works

To get a new or refill on your Topamax prescription, join our monthly membership and get discounted visits.

Paying with insurance



First month free



30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price with insurance

Often the same as an office visit. Most patients with in-network insurance pay $30 or less!

  • We accept these insurance plans and many more:

    • Humana
    • Aetna
    • Cigna

Paying without insurance



First month free



30 days of free membership

  • Same-day appointments 7 days a week

  • Unlimited messages with your Care Team

  • Prescription discount card to save up to 80%

  • Exclusive discounts on lab tests

  • Free memberships for your family

  • Cancel anytime

Visit price without insurance

Initial visits are $129.

Book an appointment

If we're unable to treat you, we'll provide a full refund.


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