Antiepileptic (sulfamate-substituted monosaccharide)
Topiramate with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Topiramate (Topiramate). Most antibiotics do not interfere meaningfully with Topiramate at 25mg, 50mg, 100mg, 200mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Antiepileptic (sulfamate-substituted monosaccharide) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Topiramate at 25mg, 50mg, 100mg, 200mg.
Practical guidance
According to the prescribing information for Topiramate, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Topiramate is co-administered. Adjusted 25mg, 50mg, 100mg, 200mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Topiramate during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Topiramate is metabolised and may need a temporary 25mg, 50mg, 100mg, 200mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Topiramate regimen.
Will antibiotics make Topiramate stop working? ▾
Most antibiotics do not affect Topiramate efficacy. Rifampicin and a few others can lower Topiramate levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Topiramate
More on Topiramate
- With alcoholTopiramate and alcohol — is it safe to drink?
- With foodShould Topiramate be taken with food?
- Side effectsTopiramate side effects: common, rare and warning signs
- Dosage guideTopiramate dosage guide: how much to take and when
- OnsetHow fast does Topiramate start working?
- DurationHow long does Topiramate last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.