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Suggest ways to wean off Topamax tablets

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Posted on Thu, 21 Jul 2016
Question: I am on a ultra low dose birth control pill, and I also take topamax 25 mg 2x a day for weight loss.
I have been getting breakthrough bleeding since starting the low dose pill 2 months ago.
My doctor and I both agree I need a higher dose Birth control pill
I understand that Topamax can make birth control pills less effective. which isn't a worry for me.
I am concerned however, that if I up my hormone to a higher level pill,(and we are going to the highest you can go) how likely is it that the topamax, 25 mg in the morning and 25 mg in the evening, will affect my system to give me breakthrough bleeding.

Also...If I decide that I want to go OFF the topamax completely, How do I wean myself off the 25mg 2x a day. The pills are tiny and you cannot cut them in half without breaking them to pieces.
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Answered by Dr. Olsi Taka (29 minutes later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

It is true that Topamax lowers the effectiveness of birth control pills. The dosage of Topamax you are taking is however a low one, so in theory it should have a lesser effect and if you increase the dose of the birth control pill you should be ok. However people metabolism and the degree it is affected by Topamax varies among individuals (in fact there can be breakthrough bleeding without Topamax at all, or not be at higher dosages of Topamax), so there can't be any guarantees about that.

As for the question on how to wean Topamax, since the dosage is low, actually 50 mg a day is the lowest possible dose, I would say that it is not necessary to divide the pills. Simply cut one pill first for one or two weeks, taking it only in the morning and then interrupt it altogether.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3674 Questions

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Suggest ways to wean off Topamax tablets

Brief Answer: Read below. Detailed Answer: I read your question carefully and I understand your concern. It is true that Topamax lowers the effectiveness of birth control pills. The dosage of Topamax you are taking is however a low one, so in theory it should have a lesser effect and if you increase the dose of the birth control pill you should be ok. However people metabolism and the degree it is affected by Topamax varies among individuals (in fact there can be breakthrough bleeding without Topamax at all, or not be at higher dosages of Topamax), so there can't be any guarantees about that. As for the question on how to wean Topamax, since the dosage is low, actually 50 mg a day is the lowest possible dose, I would say that it is not necessary to divide the pills. Simply cut one pill first for one or two weeks, taking it only in the morning and then interrupt it altogether. I hope to have been of help.