Difference between revisions of "Combining-Lithium-Topiramate"
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* This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination. | * This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination. | ||
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* Elevated and toxic lithium levels have been reported with higher (800 mg/d) doses of topiramate, but not with 500 mg/d. <ref> {{Pubmed|12006910|Pinninti at al, Does topiramate elevate serum lithium levels? J Clin Psychopharmacol. 2002 Jun;22(3):340.}}</ref> <ref> {{Pubmed|15349023|Abraham at al, Topiramate can cause lithium toxicity. J Clin Psychopharmacol. 2004 Oct;24(5):565-7}}</ref> | * Elevated and toxic lithium levels have been reported with higher (800 mg/d) doses of topiramate, but not with 500 mg/d. <ref> {{Pubmed|12006910|Pinninti at al, Does topiramate elevate serum lithium levels? J Clin Psychopharmacol. 2002 Jun;22(3):340.}}</ref> <ref> {{Pubmed|15349023|Abraham at al, Topiramate can cause lithium toxicity. J Clin Psychopharmacol. 2004 Oct;24(5):565-7}}</ref> | ||
| − | * Pharmacologic response and serum lithium levels should be monitored closely in particular after change of dosage of topiramate | + | * Pharmacologic response and serum lithium levels should be monitored closely in particular after change of dosage or discontinuation of topiramate.<ref name="drugscomint"> |
| + | {{Drugscominteract|lithium-with-topiramate-1477-0-2216-0|lithium|topiramate}}</ref> | ||
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Latest revision as of 10:56, 25 June 2010
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Adding topiramate to lithium.
General information- Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
- Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination.
Start topiramate- Start topiramate according to the general dosing advice.
Cave- Elevated and toxic lithium levels have been reported with higher (800 mg/d) doses of topiramate, but not with 500 mg/d. [2] [3]
- Pharmacologic response and serum lithium levels should be monitored closely in particular after change of dosage or discontinuation of topiramate.[4]
- ↑ 1.0 1.1 1.2 Farmacotherapeutisch Kompas - lithium (dutch)
Cite error: Invalid
<ref>tag; name "ftk" defined multiple times with different content Cite error: Invalid<ref>tag; name "ftk" defined multiple times with different content - ↑ Pinninti at al, Does topiramate elevate serum lithium levels? J Clin Psychopharmacol. 2002 Jun;22(3):340.
- ↑ Abraham at al, Topiramate can cause lithium toxicity. J Clin Psychopharmacol. 2004 Oct;24(5):565-7
- ↑ Interactions between lithium and topiramate on drugs.com
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