Patient/caregiver was educated on contraindications for using Topamax as follows:
- Metabolic acidosis induced by Topamax intake can result in increased bone dissolution and loss of calcium and phosphate minerals from the bone, resulting in demineralization of bone. This can lead to weakened skeletal framework, osteoporosis, and fractures with slightest injury. Individuals with history of osteoporosis are at increased risk for skeletal injury and fractures with Topamax use. So, Topamax is better avoided or used with caution, with periodical labs and bone scans ordered, in individuals with history of osteoporosis.
- Topamax use, over a prolonged period of time, secondary to increased bone dissolution, demineralization, and loss of calcium and phosphate minerals from the bone, can lead to formation of renal calcium stones, resulting in episodes of severe back and groin pain. The kidney stones thus formed can also obstruct the urine flow, resulting in difficulty passing urine, painful urination, retention of urine, and consequent increased risk for development of UTIs. So, Topamax is better avoided or used with caution, in individuals with history of renal stones, obstruction to urine flow, and frequent UTIs.
