Topiramate with Hydrochlorthiazide

 

Q: Which electrolyte monitoring is required when Topiramate is used with Hydrochlorthiazide (HCTZ)?

 


 

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Answer: (b) Potassium followed by (d) Bicarbonate

 


 

Clinical laboratory results indicated decreases in serum potassium after topiramate or HCTZ administration, which were greater when HCTZ and topiramate were administered in combination.

 

 

Topiramate can cause hyperchloremic, non-anion gap, metabolic acidosis:- which is decreased serum bicarbonate below the normal reference range in the absence of chronic respiratory alkalosis).

 

This metabolic acidosis is caused by renal bicarbonate loss due to carbonic anhydrase inhibition by Topiramate.

 

Note:- baseline and periodic measurement of serum bicarbonate is recommended with Topiramate.


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Dr. Harvinder Singh, M.D. (Admin)


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