Does Lithium Interact With Topiramate?

Use this combination with caution. Your prescriber may monitor you more closely or adjust doses.

Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Lithium is a mood stabilizer and Topiramate is a anticonvulsant; together they are documented as a moderate interaction. How much this matters depends on your dose, your other medications, and your overall health.

If you have been prescribed both Lithium and Topiramate, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.

7 DRUG INTERACTIONS • Contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day (7.4) • Monitor lithium levels if lithium is used with high-dose topiramate (7.7) 7.1 Antiepileptic Drugs Concomitant administration of phenytoin or carbamazepine with topiramate resulted in a clinically significant decrease in plasma concentrations of topiramate when compared to topiramate given alone.

Source: FDA structured product labeling (set_id 021005ab-6a00-40d8-9aee-20c91613b4d5).