Compare Dilantin vs. Topamax

Head-to-head comparisons of medication uses, side effects, ratings, and more.

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Dilantin (phenytoin)

Prescription only

Topamax (topiramate)

Prescription only
Treats and prevents seizures.

Dilantin (phenytoin) is very good at treating and preventing seizures, but it has many drug interactions and some serious side effects.

Prevents seizures and migraine headaches.

Topamax (topiramate) is very effective at preventing many types of seizures and migraines, but it can cause several severe side effects that can lead to stopping the medication.

3.3/ 5 average rating with 56 reviewsforTopamax
Upsides
  • If you have trouble swallowing pills, Dilantin (phenytoin) is available as a chewable tablet or a liquid.
  • Dilantin (phenytoin) is available in a cheaper, generic form.
  • Can lower your number of seizures and also prevent migraine headaches. This medicine can be used on its own or with other antiepileptic medicines to lower the frequency of seizures.
  • Doesn't need routine blood tests like similar medications.
  • Available in short-acting and long-acting forms.
  • Comes as a generic, so it's relatively cheap.
Downsides
  • Need to get regular blood tests while taking Dilantin (phenytoin) to make sure the medicine level is safe and effective in your body.
  • Can cause changes in your appearance, such as unwanted hair growth and enlargement of your gums.
  • If you have kidney problems, you’ll need regular blood tests to check your kidney function and to make sure Dilantin (phenytoin) levels in your blood don’t get too high.
  • Dilantin (phenytoin) can make other medications not work as well, including birth control.
  • Can cause many severe side effects. People starting Topamax (topiramate) need to be monitored for these effects as soon as they start treatment.
  • This medicine can take 4 to 6 weeks for the full effects of this medication to kick in, especially for people taking it for migraines.
  • Children taking Topamax (topiramate) for long periods of time need to have their dose adjusted by their pediatrician as they grow.
  • At higher doses (ie. 400 mg/day), children may experience difficulty with concentration/attention, fever, flushing, and confusion.
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Used for
Dosage forms
  • Extended release
  • Chewable tablet
  • Liquid
  • Pill
  • Extended release capsule
Price
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Reviews
Not enough review data.Leave a review
56 reviews so far
52%
saidit'sworth it
50%
saiditworked well
36%
saidit'sa big hassle

Have you used Topamax (topiramate)?

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Side effects
The Dilantin (phenytoin) FDA package insert doesn’t have numbers about how common side effects are.
39possible side effects
  • Sleepiness
    26%
  • Loss of appetite
    24%
  • Fatigue
    16%
  • Injury
    14%
  • Nervousness
    14%
  • Personality disorder (behavior problems)
    11%
  • Difficulty with concentration/attention
    10%
  • Weight loss
    9%
  • Aggressive reaction
    9%
  • Abnormal gait
    8%
  • Purpura
    8%
  • Difficulty sleeping
    8%
  • Viral infection
    7%
  • Impaired coordination
    6%
  • Nausea
    6%
  • Increased saliva
    6%
  • Muscle spasm
    5%
  • Constipation
    5%
  • Difficulty with memory
    5%
  • Pneumonia
    5%
  • Dizziness
    4%
  • Speech disorders/ related speech problems
    4%
  • Nose bleed
    4%
  • Confusion
    4%
  • Urinary incontinence
    4%
  • Stomach flu
    3%
  • Psychomotor slowing
    3%
  • Skin disorder
    3%
  • Allergic reaction
    2%
  • Abnormal reflexes
    2%
  • Thirst
    2%
  • Pussing
    2%
  • Hair loss
    2%
  • Dermatitis
    2%
  • Increased hair growth
    2%
  • Red skin rash
    2%
  • Eye abnormality
    2%
  • Abnormal vision
    2%
  • Leukopenia
    2%
See more detailed side effects
Risks and risk factors
  • Severe skin reactions
    • Asian ancestry
  • Serious liver damage
    • First 2 months of taking Dilantin (phenytoin)
  • Changes in blood cell counts
  • Suicidal thoughts or behavior
    • History of depression
  • Withdrawal seizures
    • Stopping Dilantin (phenytoin) suddenly
See more detailed risks and warnings
  • Suicidal thoughts or behavior
    • History of depression
  • Fever and inability to sweat
    • Children
  • Mental and cognitive changes
    • History of metabolic disorders
    • People also taking Depakote
  • Kidney stones
    • Low-carb diet
    • Dehydration
    • Drug interactions
  • Vision problems
  • Withdrawal seizures
    • Stopping Topamax (topiramate) suddenly
See more detailed risks and warnings