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If the decision is made to continue patients on topiramate in the face of persistent acidosis, alkali treatment should be considered.

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If you have diabetes or risk factors for diabetes (such as being overweight or having a family history of diabetes), your healthcare provider should check your blood sugar before you start taking REXULTI and during your treatment.

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However, TPM can make nutritionally vulnerable children or adult patients, with epilepsy associated with other neuropsychiatric diseases, who cannot voluntarily increase their caloric intake.

At present, there are no published prospective systematic studies of the effect of topiramate on serum pH and there is an important clinical need for studies of this nature.

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