Drug interactions between lithium and Topamax
| Results for the following 2 drugs: |
|---|
| lithium |
| Topamax (topiramate) |
Interactions between your selected drugs
lithium ↔ topiramate
Applies to:lithium and Topamax (topiramate)
MONITOR: Coadministration with topiramate may increase the serum concentrations of lithium. The exact mechanism of interaction is unknown, but may involve reduced lithium elimination due to competition by topiramate for renal excretion and/or sodium depletion secondary to the inhibitory effect of topiramate on carbonic anhydrase. There have been isolated case reports of patients treated with lithium who developed symptoms of toxicity (e.g., impaired concentration, confusion, memory loss, lethargy, tremor, bradycardia, nystagmus) in association with elevated serum lithium levels following the addition or increase in dosage of topiramate. Temporary withdrawal of lithium and dosage reduction upon reinitiation were necessary to maintain therapeutic levels during coadministration with topiramate. In healthy volunteers, topiramate at a dosage of 200 mg/day has been found to exhibit little or no pharmacokinetic interaction with lithium. However, increases of 27% in peak concentration (Cmax) and 26% in systemic exposure (AUC) of lithium have been observed following topiramate dosages of up to 600 mg/day.
MANAGEMENT: Caution is advised if lithium must be used in combination with topiramate. Pharmacologic response and serum lithium levels should be monitored closely and the dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of topiramate in patients who are stabilized on their lithium regimen. Patients should be advised to notify their physician if they experience early symptoms of lithium toxicity such as drowsiness, dizziness, diarrhea, vomiting, muscle weakness, ataxia, tremor, blurred vision, tinnitus, excessive thirst, and increased urination.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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