Topiramate
Anticonvulsant (also migraine prophylaxis)
Brand names: Topamax
Oral health effects
Dysgeusia / paresthesia
Taste alteration (notably with carbonated drinks) and oral/peripheral paresthesia are characteristic; dry mouth also occurs.
Clinical management: Reassure; reinforce caries prevention given dry mouth.
Severe mucocutaneous reactions (SJS/TEN, rare)
Rare but serious skin reactions such as Stevens-Johnson syndrome, with painful oral ulceration, are a label warning.
Clinical management: Ask about new rash, fever or mouth ulcers, especially in the first two months of therapy. Painful erosions of the lips and mouth with skin rash are a medical emergency: refer urgently to the physician and do not delay for dental treatment.
Sources
- A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Wolff A, Joshi RK, Ekström J, et al. Drugs in R&D, 2017.
- A review and guide to drug-associated oral adverse effects-Dental, salivary and neurosensory reactions. Part 1. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
- Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.
- Topiramate prescribing information (FDA label) REMEDYREPACK INC. / DailyMed, 2026.
- A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.