Taking topamax (topiramate) with fioricet, is this okay?

Yes, but wean down: Yes, the Fioricet will stop headaches that occur, while the topamax (topiramate) will keep them from coming on in the first place. That being said, if you are still using the Fioricet on a regular basis, you should definitely look into alternative medications- Fioricet has been shown to greatly increase the risk of medication overuse headache, which is very difficulty to treat.

Drug safety: Can be used together - but there is potential for moderate clinically significant interactions. Per Drugs.Com drug interaction checker. "Using butalbital together with topiramate may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating." Using acetaminophen together with butalbital can affect liver.

Not so OK: Am puzzled as to what is being treated as this is not a combination I ever used in decades of practice. In my state, this likely would be investigated regarding indications