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Suicidal thoughts or behaviors Seizures (from withdrawal) Vision problems: blurred vision, loss of vision, double vision, blind spots Serious bleeds: bleeding that’s difficult to stop, vomiting blood, blood in the urine or stool, “coffee-ground” stool Severe skin reactions: rash, skin pain or peeling, blisters, fever, sore throat, extreme tiredness, swelling of the face, swollen lips Extreme drop in body temperature: shivering, feeling tired, feeling confused, slurred speech, coma Dangerously high body temperature: fever, headache, dizziness, feeling confused, nausea, vomiting muscle cramps, skin that’s very warm or hot to the touch Dangerously high blood acid levels: feeling very tired, breathing very fast, poor appetite, irregular heartbeat, trouble thinking clearly, sharp pain near the side and back from kidney stones Extremely high blood ammonia levels: fatigue, poor mental alertness, vomiting Effects of other drugs, drug classes and over-the-counter products on Topamax The following medications may interact with Topamax: Contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day Monitor lithium levels if lithium is used with high-dose Topamax Who makes Topamax

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A 2023 systematic review and meta-analysis of 82 RCTs (10,332 patients) examined probiotics for IBS symptoms, and for abdominal bloating or distension reported only very low certainty in the evidence for a benefit, with some specific combination probiotics and Bacillus strains showing potential signals.[5] Certainty grading reflects how confident the analysis is in the effect estimate