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WARNING Before using topiramate, tell your health care provider about your medical history, especially if you have: narrow angle glaucoma and nearsightedness kidney problems, such as kidney stones liver problems depression or thoughts of suicide lung or breathing problems metabolic acidosis high blood ammonia levels long-term diarrhea low body temperature a diet high in fat and low in carbohydrates, aka a ketogenic diet brittle bones Topiramate may cause some people to sweat less
The methylcobalamin component does not require dose adjustment for hepatic or renal impairment, as vitamin B12 metabolism and elimination are not significantly affected by organ dysfunction at the doses used in this formulation
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