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have kidney problems kidney stones or are getting kidney dialysis ; have a history of metabolic acidosis too much acid in the blood ; have liver problems ; have weak brittle or soft bones osteomalacia osteoporosis osteopenia or decreased bone density ; have lung or breathing problems ; have eye problems especially glaucoma ; have diarrhea ; have a growth problem ; are on a diet high in fat and low in carbohydrates which is called a ketogenic diet ; are having surgery ; are pregnant or plan to become pregnant ; or if you are breastfeeding . the medicine in qudexy xr topiramate passes into your breast milk . it is not known if the medicine topiramate that passes into breast milk can harm your baby . talk to your doctor about the best way to feed your baby if you take qudexy xr . also tell your doctor about all the medicines you take including prescription and over the counter medicines vitamins and herbal supplements . especially tell your doctor if you take metformin e.g. glucophage ; valproic acid e.g. depakene or depakote ; any medicines that impair or decrease your thinking concentration or muscle coordination ; birth control pills ; medicines used to prevent seizures ; or any other carbonic anhydrase inhibitors e.g. zonisamide acetazolamide or dichlorphenamide . qudexy xr may make your birth control pills less effective . ask your doctor if you are not sure if your medicine is listed above . what should i watch for after starting qudexy xr qudexy xr can cause serious side effects including eye problems . serious eye problems include blurred vision sudden decrease in vision with or without eye pain and redness and a blockage of fluid that may cause increased pressure in the eye secondary angle closure glaucoma . if left untreated these can lead to permanent vision loss . decreased sweating and fever . people especially children should be watched for signs of decreased sweating and fever especially in hot temperatures . some people may need to be hospitalized for this condition . increased acid level in your blood metabolic acidosis . this may or may not cause symptoms . symptoms may include feeling tired decreased appetite change in heartbeat or trouble thinking clearly . if left untreated metabolic acidosis can cause brittle or soft bones osteoporosis osteomalacia osteopenia kidney stones can slow the rate of growth in children and may harm your baby if you are pregnant . high blood ammonia levels . high ammonia in the blood can affect mental activities slow alertness cause tiredness or cause vomiting . this can also happen when qudexy xr is taken with a medicine called valproic acid e.g. depakene and depakote . kidney stones . drink plenty of fluids when taking qudexy xr to decrease your chances of getting kidney stones . low body temperature . taking qudexy xr when you are also taking valproic acid may cause a drop in body temperature to less than 95 f tiredness confusion or coma . effects on thinking and alertness . qudexy xr may affect how you think and can cause confusion and problems with concentration attention memory or speech . qudexy xr may cause depression or mood problems tiredness and sleepiness . dizziness or loss of muscle coordination . call your doctor right away if you have any of the above symptoms . the most common side effects of qudexy xr include tingling of the arms and legs paresthesia not feeling hungry weight loss nervousness speech problems tiredness dizziness sleepiness drowsiness slow reactions difficulty with memory fever and abnormal vision . these are not all the possible side effects of qudexy xr . for more information ask your doctor or pharmacist . like other antiepileptic drugs qudexy xr may cause suicidal thoughts or actions in a very small number of people about 1 in 500 . call a doctor right away if you have any of these symptoms especially if they are new worse or worry you thoughts about suicide or dying ; attempts to commit suicide ; new or worse depression or anxiety ; feel agitated or restless ; experience panic attacks ; trouble sleeping insomnia ; new or worse irritability ; feel or act aggressive angry or violent ; act on dangerous impulses ; an extreme increase in activity and talking mania ; other unusual changes in behavior or mood . qudexy xr can harm your unborn baby . all women of childbearing age should talk to their doctors about possible alternative treatments . if you take qudexy xr during pregnancy your baby has a higher risk for birth defects called cleft lip and cleft palate . these defects can begin early in pregnancy even before you know you are pregnant . if the decision is made to use qudexy xr you should use effective birth control contraception unless you are planning to become pregnant . tell your doctor right away if you become pregnant while taking qudexy xr . do not stop qudexy xr without first talking to a doctor . if you have epilepsy and you stop taking qudexy xr suddenly you may have seizures that do not stop . your doctor will tell you how to stop taking qudexy xr slowly . what should i avoid while taking qudexy xr do not drink alcohol while taking qudexy xr . qudexy xr and alcohol can cause serious side effects such as severe sleepiness and dizziness and an increase in seizures . do not drive a car swim climb or operate heavy machinery until you know how qudexy xr affects you . qudexy xr can slow your thinking and motor skills and may affect vision . even when taking qudexy xr some patients with epilepsy will continue to have unpredictable seizures . how should i take qudexy xr take qudexy xr exactly as your doctor tells you to . you may swallow qudexy xr capsules whole or if you can not swallow the capsule whole you may carefully open the qudexy xr capsule and sprinkle the medicine on a spoonful of soft food like applesauce . swallow the food and medicine mixture right away . do not store the food and medicine mixture to use later or crush or chew the food and medicine mixture before swallowing . this is the most important information to know about qudexy xr . for more information talk to your health care provider and read the medication guide for qudexy xr . you can also visit www.upsher smith.com or call 1 888 650 3789 . indicationsqudexy xr topiramate extended release capsules is a prescription medicine used to treat certain types of seizures partial onset seizures and primary generalized tonic clonic seizures and with other medicines to treat certain types of seizures partial onset seizures primary generalized tonic clonic seizures and seizures associated with lennox gastaut syndrome in adults and children 2 years and older . you are encouraged to report negative side effects of prescription drugs to the fda . visit www.fda.gov medwatch or call 1 800 fda 1088 . qudexy is a registered trademark of upsher smith laboratories inc. all other marks are the property of their respective owners . advancing pharmacotherapy . improving life . home contact us products a z site map open jobs privacy policy legal notices upsher smith laboratories inc. 6701 evenstad drive maple grove mn 55369 1 800 654 2299 2016 upsher smith laboratories inc. all rights reserved .