Patient/caregiver was educated on precautions to be exercised while taking 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. Report unusual skeletal and bone pain, if any, to your physician for further evaluation. Observe compliance with periodical labs and bone scans ordered.
- 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 abdominal, 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. Report to your physician regarding abdominal, back, and groin pain, unexplained fever and chills, difficulty passing urine, and painful urination, so that, your plan of care could be revised accordingly. Observing compliance with intake of liberal amounts of water can help reduce the formation of kidney stones with Topamax. Observing compliance timed voiding, hygienic practices, and other UTI prevention measures can help reduce the risk of urinary retention and prevent development of any UTIs, secondary to Topamax intake.
