Diamox and Topiragen

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using acetaZOLAMIDE together with topiramate. 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.

GENERALLY AVOID: Concomitant use of carbonic anhydrase inhibitors such as acetazolamide, topiramate, and zonisamide with each other or with other carbonic anhydrase inhibitors may increase the risk and severity of metabolic acidosis as well as the risk of kidney stone formation due to possible additive pharmacologic effects. Carbonic anhydrase inhibitors can decrease serum bicarbonate in a dose-related manner and induce non-anion gap, hyperchloremic metabolic acidosis. In addition, they can promote stone formation by reducing urinary citrate excretion and increasing urinary pH. Because they alter electrolyte and fluid balance, carbonic anhydrase inhibitors may also predispose patients to heat-related disorders. Oligohidrosis and hyperthermia have specifically been reported with the use of topiramate or zonisamide, particularly in pediatric patients, and coadministration with other carbonic anhydrase inhibitors may potentiate the risk according to the manufacturers. Oligohidrosis and hyperthermia are sometimes associated with serious sequelae, but may be preventable by prompt recognition of symptoms and appropriate treatment.

MANAGEMENT: The use of more than one carbonic anhydrase inhibitor at a time is generally not recommended. Patients receiving treatment with a carbonic anhydrase inhibitor should have baseline and periodic measurements of serum bicarbonate. If metabolic acidosis develops and persists, consideration should be given to reducing the dosage or discontinuing treatment. Manifestations of acute or chronic metabolic acidosis may include hyperventilation, nonspecific symptoms such as fatigue and anorexia, or more severe sequelae like cardiac arrhythmias or stupor. If left untreated, metabolic acidosis can also lead to nephrolithiasis or nephrocalcinosis, osteomalacia (or rickets in children), osteoporosis, and reduced growth rates in pediatric patients. Increased fluid intake is recommended during therapy with carbonic anhydrase inhibitors to increase urinary output, which lowers the concentration of substances involved in stone formation. Patients, particularly pediatric patients, should be monitored closely for evidence of decreased sweating and increased body temperature, especially in warm or hot weather. Proper hydration before and during vigorous activities or exposure to warm temperatures is recommended. Patients (or their guardians or caregivers) should contact their doctor immediately if they develop signs or symptoms of kidney stones such as sudden back pain, abdominal pain and/or blood in the urine, of if they are not sweating as usual, with or without a fever. Carbonic anhydrase inhibitors should be used cautiously in the presence of predisposing factors to acidosis, such as renal impairment, severe respiratory disorders, status epilepticus, prolonged or severe diarrhea, a ketogenic diet (i.e., high protein/low carbohydrate), or surgery.

Diamox

Generic Name: acetazolamide

Brand name: Diamox, Diamox Sequels

Synonyms: n.a.

What is Diamox?

Topiragen

Generic Name: topiramate

Brand name: Qudexy XR Sprinkle, Topamax, Topamax Sprinkle, Trokendi XR, Qudexy XR, Topiragen

Synonyms: Topiragen (Oral)

What is Topiragen?