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Carbamazepine (Tegretol) and phenytoin (Dilantin) markedly decrease the amount of topamax in the body by increasing its elimination from the body. As a result, topamax may lose effectiveness unless doses are increased. Topamax may decrease the amount of estrogen in the body in women taking oral contraceptives, possibly increasing the chances of unwanted pregnancy. Patients with seizure disorders taking anticonvulsant medications, including topamax, may develop nerve toxicity from a chemical, 4'-O-methylpyridoxine, found as a contaminant in some ginkgo preparations. Do not take this medicine if Topamax And Loss Of Skin Elasticity you have had an allergic reaction to it or are allergic to any ingredient in this product. Do not stop using this medicine without first checking with your doctor. Some conditions may become worse when the medicine is suddenly stopped. Keep all doctor and laboratory appointments while you are using this medicine. Laboratory and/or medical tests may be done, such as measuring bicarbonate levels in your blood, before you start taking this medicine and during therapy to monitor for side effects. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are taking this medicine. This medicine will add to the effects of alcohol and other depressants. Ask your doctor or pharmacist if you have questions. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. This medicine may reduce sweating which could raise your body temperature, especially in children. The risk of this serious side effect is greater in hot weather and/or during vigorous exercise. Drink plenty of fluids and dress lightly while in hot climates, or when exercising. Check carefully for signs of decreased sweating. If this occurs, promptly seek cooler or air-conditioned shelter and/or stop exercising. Seek immediate medical attention if your body temperature is above normal, or if you have mental or mood changes, headache, or dizziness. Contact your doctor for more details. Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. For women, taking this medicine while you are using birth control pills may decrease the effectiveness of your birth control pills. To prevent pregnancy, use an additional form of birth control while you are taking this medicine. Ask your doctor or pharmacist if you need more information. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. It is unknown if this medicine is excreted in breast milk. 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