Published: 3 September 2020


Avoid switching brands of topiramate

Published: 3 September 2020
Prescriber Update 41(3): 51
September 2020

Medsafe is reminding healthcare professionals that some medicines need to be prescribed by brand.1 This reminder follows a recent report to the Centre for Adverse Reactions Monitoring (CARM ID: 136121) of a patient who experienced pre-seizure symptoms after changing brands of topiramate.

Changing brands of topiramate should be avoided if possible. Medsafe recommends prescribers follow the UK Medicines and Healthcare products Regulatory Agency’s (MHRA) advice on switching brands of antiepileptic medicines.2 Brand switches for topiramate must be carefully considered, taking into account factors such as seizure frequency and treatment history.2

Checking with patients which brand of topiramate they are taking and prescribing by brand will help to ensure patients receive the brand they are stabilised on.


  1. Medsafe. 2019. Some medicines need to be prescribed by brand. Prescriber Update 40(4): 68–9. URL: (accessed 17 June 2020).
  2. Medicines and Healthcare products Regulatory Agency. 2017. Antiepileptic drugs: updated advice on switching between different manufacturers’ products. Drug Safety Update 11(4): 5. URL: (accessed 17 June 2020).
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