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Drug interactions between Topamax and Zonegran

Results for the following 2 drugs:
Topamax (topiramate)
Zonegran (zonisamide)

Interactions between your drugs

Major

topiramate zonisamide

Applies to: Topamax (topiramate) and Zonegran (zonisamide)

Talk to your doctor before using topiramate together with zonisamide. Both of these medications can cause metabolic acidosis, a condition associated with elevated levels of acid in the blood, and combining them may increase the risk as well as severity of the condition. Patients with metabolic acidosis may have no symptoms at all, or they may experience tiredness, loss of appetite, irregular heartbeat, trouble thinking clearly, and rapid breathing. If left untreated, metabolic acidosis can also lead to kidney stones, brittle or soft bones (osteomalacia, osteopenia, osteoporosis), reduced growth rates in children, and harm to the unborn baby during pregnancy. Patients receiving these medications, whether together or alone, generally require a blood test to measure the level of acid in the blood before and during treatment. Another potential issue with combining these medications is the risk of heat-related disorders. Decreased sweating and increased body temperature have been reported, particularly in children. Heat stroke may occur during vigorous exercise or prolonged exposure to warm or hot weather. Increased fluid intake is recommended during treatment to help prevent heat-related problems and kidney stones. Contact your doctor immediately if you develop signs or symptoms of kidney stones such as sudden back pain, abdominal pain and blood in the urine, of if you have decreased sweating or a fever. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

zonisamide food

Applies to: Zonegran (zonisamide)

Alcohol can increase the nervous system side effects of zonisamide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with zonisamide. Do not use more than the recommended dose of zonisamide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Carbonic anhydrase inhibitor anticonvulsants

Therapeutic duplication

The recommended maximum number of medicines in the 'carbonic anhydrase inhibitor anticonvulsants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'carbonic anhydrase inhibitor anticonvulsants' category:

  • topiramate
  • zonisamide

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

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.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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