Drug Interactions With Topiramate
Alcohol and CNS Depressants
Topiramate should be used with extreme caution in combination with alcohol or other medications that can cause drowsiness (known as CNS depressants or central nervous system depressants). Excessive drowsiness, depression, confusion, or other problems may occur.
Topiramate can increase the level of amitriptyline in your blood, increasing your risk of side effects. Also, since amitriptyline can act as a CNS depressant (see above), excessive drowsiness or other side effects may occur.
Carbonic Anhydrase Inhibitors
Combining topiramate with carbonic anhydrase inhibitors can increase your risk of certain side effects, such as kidney stones or decreased sweating. Talk to your healthcare provider before using these medications together.
Carbamazepine (Tegretol, Tegretol XR)
Carbamazepine can decrease the level of topiramate in your blood, perhaps making it less effective. Your healthcare provider may need to adjust your topiramate dosage, especially when starting or stopping carbamazepine.
Digoxin (Digitek, Lanoxin)
Topiramate can decrease the level of digoxin in your blood, perhaps making it less effective. Your healthcare provider may need to monitor the level of digoxin in your blood and adjust your digoxin dosage as necessary, especially when starting or stopping topiramate.
Hydrochlorothiazide (Esidrix, HydroDIURIL, Microzide, Oretic)