Patient/caregiver was educated on precautions to be exercised while taking topiramate as follows:
- Topiramate, by increasing loss of bicarbonate ions from the body, can result in excess of acid ions in the body, which consequently can lead to a dangerous acidotic condition called metabolic acidosis. Individuals can present with rapid heart rate and fast breathing patterns, to compensate for the acidosis. Patients can also present with episodes of confusion and extreme tiredness. Upon presentation with any of such findings, report them to your physician and other health care personnel, for any change in plan of care to be considered.
- Fluid deficient states, such as, dehydration and diarrhea, can also result in significant loss of bicarbonate ions and are naturally prone for developing metabolic acidosis. Use of topiramate in such individuals can tip the acid-base balance easily, to favor a state of excess acid in the body and result in metabolic acidosis. Liberal intake of fluid, atleast 8-10 glasses a day, during topiramate intake, can contribute significantly to prevent development of metabolic acidosis.
- A number of medications, such as, oral antidiabetics (metformin) and diuretics (acetazolamide), either by increasing the acid or by decreasing the base in the body, can also result in metabolic acidosis. Taken concurrently, the effect of these medications causing metabolic acidosis can be complemented by topiramate, thus increasing this risk steeply. If you are being newly started on topiramate, discuss with your physician regarding all other medications you are currently taking and their safety with topiramate. Also, if you have been taking topiramate for long, discuss with your physician regarding your history of topiramate intake, when you are being started on any new medication.
