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Phentermine / topiramate Disease Interactions

There are 25 disease interactions with phentermine / topiramate:

Major

Amphetamines (Includes Phentermine/topiramate) ↔ Cardiovascular

Severe Potential Hazard, High plausibility

Applies to: Cardiovascular Disease, Hyperthyroidism, Cerebral Vascular Disorder, History - Myocardial Infarction, History - Cerebrovascular Disease

The use of amphetamines and amphetamine-like drugs is contraindicated in patients with advanced arteriosclerosis, symptomatic or unstable cardio- or cerebrovascular disease, moderate to severe hypertension, or hyperthyroidism. Like other sympathomimetic amines, amphetamines may cause cardiovascular adverse effects such as palpitation, tachycardia, cardiac arrhythmias, and elevation of blood pressure. Rarely, cardiomyopathy manifested as ventricular hypertrophy and/or congestive heart failure has been reported during chronic amphetamine use. In addition, sudden death has been reported in association with amphetamine therapy at usual dosages in children with structural cardiac abnormalities. In general, amphetamines should not be used in patients with structural cardiac abnormalities. If not otherwise contraindicated, therapy with amphetamines should be administered cautiously in patients with a current or past history of cardiovascular or cerebrovascular disease.

References

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Desoxyn (methamphetamine)" Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
View all 15 references
Major

Amphetamines (Includes Phentermine/topiramate) ↔ Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma (Narrow Angle)

The use of amphetamines and amphetamine-like drugs is contraindicated in patients with narrow-angle glaucoma or anatomically narrow angles. Like other sympathomimetic amines, amphetamines can induce transient mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. If possible, these agents should also be avoided in patients with other forms of glaucoma, since mydriasis may occasionally increase intraocular pressure.

References

  1. "Product Information. Dexedrine (dextroamphetamine)" SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Tenuate (diethylpropion)" Aventis Pharmaceuticals, Swiftwater, PA.
  3. "Product Information. Prelu-2 (phendimetrazine)" Boehringer-Ingelheim, Ridgefield, CT.
View all 8 references
Major

Carbonic Anhy. Inhibitors (Includes Phentermine/topiramate) ↔ Bone Marrow Depression/Blood Dyscrasias

Severe Potential Hazard, Moderate plausibility

Applies to: History - Blood Dyscrasias, Bone Marrow Depression/Low Blood Counts

The use of carbonic anhydrase inhibitors may rarely cause bone marrow suppression and blood dyscrasias at recommended dosages. Aplastic anemia, thrombocytopenia or thrombocytopenia purpura, leukopenia, agranulocytosis, and hemolytic anemia have been reported. Extreme caution should be exercised if carbonic anhydrase inhibitors are administered to patients with these preexisting conditions. A baseline CBC and platelet count is recommended, as well as monitoring at regular intervals during therapy.

References

  1. McWhae JA, Chang J, Lipton JH "Drug-induced fatal aplastic anemia following cataract surgery." Can J Ophthalmol 27 (1992): 313-5
  2. Lubeck MJ "Aplastic anemia following acetazolamide therapy." Am J Ophthalmol 69 (1970): 684-5
  3. Rentiers PK, Johnston AC, Buskard N "Severe aplastic anemia as a complication of acetazolamide therapy." Can J Ophthalmol 5 (1970): 337-42
View all 9 references
Major

Carbonic Anhydrase Inhibitor Anticonvulsants (Includes Phentermine/topiramate) ↔ Oligohidrosis/Hyperthermia

Severe Potential Hazard, Moderate plausibility

Applies to: Fever

Oligohidrosis (decreased sweating) and hyperthermia have been reported in association with the use of some carbonic anhydrase inhibitor anticonvulsants such as topiramate and zonisamide. Most of the reports have been in children. Caution and close monitoring of body temperature is advised when prescribing these drugs, especially in patients with a fever, in hot weather, or if combined with other drugs that predispose to heat related disorders. Zonisamide is not approved for use in pediatric patients in the U.S.

References

  1. "Product Information. Zonegran (zonisamide)" Elan Pharmaceuticals, S. San Francisco, CA.
  2. Shimizu T, Yamashita Y, Satoi M, Togo A, Wada N, Matsuishi T, Ohnishi A, Kato H "Heat stroke-like episode in a child caused by zonisamide." Brain Dev 19 (1997): 366-8
Major

Carbonic Anhydrase Inhibitors (Includes Phentermine/topiramate) ↔ Severe Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Cirrhosis

The use of carbonic anhydrase inhibitors is contraindicated in patients with marked liver disease or cirrhosis. Carbonic anhydrase inhibitors increase the risk of developing hepatic encephalopathy in these patients. Extreme caution should be exercised if carbonic anhydrase inhibitors are administered in patients with mild to moderate liver disease as the clearance of the drug can be decreased. A dose reduction might be needed and monitoring of the liver function is recommended.

References

  1. Margo CE "Acetazolamide and advanced liver disease." Am J Ophthalmol 101 (1986): 611-2
  2. "Product Information. Diamox (acetazolamide)." Lederle Laboratories, Wayne, NJ.
  3. Maren TH "Acetazolamide and advanced liver disease ." Am J Ophthalmol 102 (1986): 672-3
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Agitation

Severe Potential Hazard, High plausibility

Applies to: Psychosis, Anxiety/Stress, Neurosis

The use of central nervous system (CNS) stimulants is contraindicated in patients with marked agitation and/or anxiety, since these symptoms may be aggravated. CNS stimulants may also exacerbate symptoms of behavior disturbance and thought disorder in psychotic patients, particularly children. Therapy with CNS stimulants should be administered cautiously in patients with a history of psychosis or a predisposition to agitated states.

References

  1. "Product Information. Prelu-2 (phendimetrazine)" Boehringer-Ingelheim, Ridgefield, CT.
  2. "Product Information. Tenuate (diethylpropion)" Aventis Pharmaceuticals, Swiftwater, PA.
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)" Shire Richwood Pharmaceutical Company, Florence, KY.
View all 11 references
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Cardiac Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Heart Disease, Hypertension, Pheochromocytoma, Hyperthyroidism, Peripheral Arterial Disease

The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma (Narrow Angle)

The use of most CNS stimulants is contraindicated in patients with glaucoma, as these agents exhibit sympathomimetic activity and may induce mydriasis provoking an increase in intraocular pressure.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension

CNS stimulant medications have shown to increase blood pressure and their use is contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Pulmonary Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Valvular Heart Disease, Syncope

The use of some CNS stimulants has been associated with an increased risk of developing pulmonary hypertension, a rare but fatal disorder. The onset or aggravation of exertional dyspnea, or unexplained symptoms of angina pectoris, syncope, or lower extremity edema suggest the possibility of occurrence of pulmonary hypertension. Under these circumstances, treatment must be immediately discontinued, and the patient should be evaluated to confirm diagnosis. Caution should be exercised in patients with preexisting valvular heart disease or history of pulmonary hypertension. These drugs are not recommended in patients with known heart murmur or valvular heart disease.

Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Seizure Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
Major

Cns Stimulants (Includes Phentermine/topiramate) ↔ Substance Abuse

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Drug Abuse/Dependence

Central nervous system (CNS) stimulants, especially amphetamines, have significant potential for habituation and abuse. Tolerance, psychological dependence and severe social dysfunction can develop after prolonged use. Frank psychotic episodes may also occur in association with chronic intoxication. Therapy with CNS stimulants should be administered cautiously, if at all, in patients with a history of alcohol or substance abuse. The use of amphetamines is considered by manufacturers to be contraindicated in such patients.

References

  1. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Desoxyn (methamphetamine)" Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Fastin (phentermine)." SmithKline Beecham, Philadelphia, PA.
View all 11 references
Major

Topiramate (Includes Phentermine/topiramate) ↔ Metabolic Acidosis

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction, Acidosis, Pulmonary Impairment, Diarrhea, Alcoholism, Anemia, Asphyxia, Congestive Heart Failure, Dehydration, Myocardial Infarction, Shock, Vomiting, Sepsis, Diabetes Mellitus

The use of topiramate is associated with hyperchloremic, nonanion-gap metabolic acidosis, which is characterized by decreased serum bicarbonate below the normal reference range in the absence of chronic respiratory alkalosis. The condition usually occurs early in treatment and is caused by renal bicarbonate loss due to the inhibitory effect of topiramate on carbonic anhydrase. Bicarbonate decreases are generally mild to moderate, averaging 4 mEq/L at dosages of 400 mg/day in adults and approximately 6 mg/kg/day in pediatric patients. However, metabolic acidosis has been observed at dosages as low as 50 mg/day in adults and in patients as young as 5 months old, especially at dosages above 5 mg/kg/day. Rarely, patients may experience severe decrements to values below 10 mEq/L. Therapy with topiramate should be administered cautiously in patients with conditions that predispose to acidosis, including severe respiratory disease, renal disease, poorly controlled diabetes, alcoholism, congestive heart failure requiring pharmacologic treatment (especially unstable or acute CHF where there is risk of hypoperfusion and hypoxemia), and any condition associated with hypoxemia (e.g., severe anemia, myocardial infarction, asphyxia, shock), dehydration (e.g., severe diarrhea or vomiting), or sepsis. All patients prescribed topiramate should have serum bicarbonate measured at baseline and periodically, and be advised of the significance of nonspecific symptoms such as malaise, anorexia, respiratory distress, increasing somnolence, and gastrointestinal disturbances that may indicate early acidosis. More marked acidosis may be associated with cardiac arrhythmias and stupor. Chronic, untreated metabolic acidosis may increase the risk for nephrolithiasis or nephrocalcinosis, and may also cause osteomalacia, osteoporosis, and reduced growth rates in pediatric patients. If metabolic acidosis develops and persists, consideration should be given to reducing the dosage or discontinuing topiramate. If the decision is made to continue topiramate, alkali treatment should be considered.

References

  1. Stowe CD, Bollinger T, James LP, Haley TM, Griebel ML, Farrar HC "Acute mental status changes and hyperchloremic metabolic acidosis with long-term topiramate therapy." Pharmacotherapy 20 (2000): 105-9
  2. "Product Information. Topamax (topiramate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  3. Philippi H, Boor R, Reitter B "Topiramate and metabolic acidosis in infants and toddlers." Epilepsia 43 (2002): 744-7
Moderate

Antiepileptics (Includes Phentermine/topiramate) ↔ Suicidal Tendency

Moderate Potential Hazard, Moderate plausibility

Applies to: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately one case for every 530 patients treated. There were four suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as one week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.

Moderate

Carbonic Anhydrase Inhibitor Anticonvulsants (Includes Phentermine/topiramate) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

The major route of elimination of carbonic anhydrase inhibitors is through the kidney. These drugs should be administered cautiously in patients with reduced renal function and a dose adjustment might be required depending on the level of impairment.

Moderate

Carbonic Anhydrase Inhibitors (Includes Phentermine/topiramate) ↔ Metabolic Acidosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Acidosis, Renal Dysfunction, Chronic Obstructive Pulmonary Disease, Diarrhea

Reduced plasma bicarbonate levels and, in some instances, elevated plasma chloride levels may result in metabolic acidosis during long-term therapy with carbonic anhydrase inhibitors. Therapy with carbonic anhydrase inhibitors should be administered cautiously in patients with metabolic or hyperchloremic acidosis or with conditions that predispose to acidosis (renal disease, severe respiratory disorders, diarrhea). The measurement of baseline and periodic serum bicarbonate is recommended. If metabolic acidosis develops (it may be corrected by administration of sodium bicarbonate), and persists, a dose reduction or treatment discontinuation should be considered.

References

  1. Cowan RA, Hartnell GG, Lowdell CP, Baird IM, Leak AM "Metabolic acidosis induced by carbonic anhydrase inhibitors and salicylates in patients with normal renal function." Br Med J (Clin Res Ed) 289 (1984): 347-8
  2. Heller I, Halevy J, Cohen S, Theodor E "Significant metabolic acidosis induced by acetazolamide: not a rare complication." Arch Intern Med 145 (1985): 1815-7
  3. Berthelsen P "Cardiovascular performance and oxyhemoglobin dissociation after acetazolamide in metabolic alkalosis." Intensive Care Med 8 (1982): 269-74
View all 10 references
Moderate

Cns Stimulants (Includes Phentermine/topiramate) ↔ Psychiatric Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Bipolar Disorder, Depression, Mania

The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Cns Stimulants (Includes Phentermine/topiramate) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Cns Stimulants (Includes Phentermine/topiramate) ↔ Tics

Moderate Potential Hazard, High plausibility

Applies to: Tic Disorder

Central nervous system (CNS) stimulants have been reported to exacerbate Tourette's syndrome and other motor and phonic tics. Therapy with CNS stimulants, if necessary, should be administered cautiously in patients with tic disorders or family history of Tourette's syndrome. The manufacturers of the CNS stimulants, methylphenidate (racemic) and dexmethylphenidate (the more pharmacologically active d-enantiomer), consider their use to be contraindicated in such patients.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Fastin (phentermine)." SmithKline Beecham, Philadelphia, PA.
  3. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
View all 11 references
Moderate

Obesity Drugs (Includes Phentermine/topiramate) ↔ Diabetics

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Type 2

Obese, type 2 diabetic patients who achieve weight loss may demonstrate improved metabolic control of their disease as a result of their reduced weight. Therefore, patients with type 2 diabetes mellitus should be monitored during weight-reduction therapy (or therapy that may be expected to induce significant weight loss as a secondary effect) for hypoglycemia and reduced need for oral hypoglycemic medication or insulin, and the dosages of these agents adjusted accordingly. Patients should be apprised of the risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation.

References

  1. "Product Information. Meridia (sibutramine)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. "Product Information. Xenical (orlistat)." Roche Laboratories, Nutley, NJ.
  3. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
View all 9 references
Moderate

Phentermine (Includes Phentermine/topiramate) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Phentermine may be partially metabolized in the liver. Following administration of a single 15 mg-92 mg dose of phentermine-topiramate, mean phentermine systemic exposure (AUC) was 37% and 60% higher in patients with mild (Child-Pugh score 5 to 6) and moderate (Child-Pugh score 7 to 9) hepatic impairment, respectively, compared to healthy volunteers. No dosage adjustment is necessary in patients with mild hepatic impairment. In patients with moderate hepatic impairment, a reduction in the starting and/or maintenance dosage may be necessary in accordance with the individual product package labeling. Phentermine pharmacokinetics have not been studied in patients with severe hepatic impairment (Child-Pugh score 10 to 15); therefore, use should be avoided.

Moderate

Topiramate (Includes Phentermine/topiramate) ↔ Angle Closure Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Myopia

A syndrome consisting of acute myopia associated with secondary angle closure glaucoma has been reported in patients receiving topiramate. Symptoms include acute onset of visual acuity and/or ocular pain. It typically occurs within 1 month of treatment initiation and it has been reported in both pediatric and adult patients. Caution is recommended when prescribing topiramate in patients with elevated intraocular pressure regardless of the etiology.

Moderate

Topiramate (Includes Phentermine/topiramate) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Topiramate is cleared by hemodialysis at a rate that is 4 to 6 times greater than that in a normal individual. A prolonged period of dialysis may cause plasma topiramate level to fall below that required to maintain an anti-seizure effect, thus a supplemental dose may be required in patients undergoing hemodialysis. The actual adjustment should take into account the duration of dialysis, the clearance rate of the dialysis system being used, and the effective renal clearance of topiramate in the patient being dialyzed.

References

  1. "Product Information. Topamax (topiramate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
Moderate

Topiramate (Includes Phentermine/topiramate) ↔ Nephrolithiasis

Moderate Potential Hazard, Moderate plausibility

Applies to: Nephrolithiasis, Dehydration, History - Nephrolithiasis

The use of topiramate may infrequently be associated with the development of kidney stones. The reported incidence was 1.5% (32 of 2,086 patients) during premarketing use, which is about 2 to 4 times that expected in a similar, untreated population. Topiramate is a weak carbonic anhydrase inhibitor and may promote stone formation by reducing urinary citrate excretion and increasing urinary pH. Therapy with topiramate should be administered cautiously with adequate hydration in patients with a history of nephrolithiasis. The concomitant use of topiramate with other carbonic anhydrase inhibitors should be avoided. Patients who are dehydrated may be at increased risk for the development of nephrolithiasis and should be encouraged to consume additional amounts of liquid during topiramate therapy.

References

  1. "Product Information. Topamax (topiramate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. Shorvon SD "Safety of topiramate: adverse events and relationships to dosing." Epilepsia 37(suppl 2 (1996): s18-22

phentermine / topiramate drug Interactions

There are 781 drug interactions with phentermine / topiramate

phentermine / topiramate alcohol/food Interactions

There are 3 alcohol/food interactions with phentermine / topiramate

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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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