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Created page with '{{Drugcombi | base = Lithium | add = Topiramate | info = * Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects. * Topi...'
{{Drugcombi
| base = Lithium
| add = Topiramate
| info =
* 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 inhibiter 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 =
* 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. <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 or discontinuation.
}}
| base = Lithium
| add = Topiramate
| info =
* 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 inhibiter 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 =
* 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. <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 or discontinuation.
}}