Shauna S Garris1, Karen S Oles. 1. Department of Pharmacy, Medical University of South Carolina, Charleston, SC, USA.
Abstract
BACKGROUND: Topiramate is an antiepileptic medication with multiple pharmacologic effects, including inhibition of carbonic anhydrase activity. It is associated with metabolic acidosis in both children and adults. OBJECTIVE: To evaluate the incidence and magnitude of the effect of topiramate on serum bicarbonate concentrations in an adult population. METHODS: This was a retrospective cohort study. Data were evaluated to assess the relationship between serum bicarbonate concentrations before and during topiramate therapy. RESULTS: Fifty-four patients (40 females) with a mean age of 47.6 years (range 19-89) were included in the study. Mean +/- SD serum bicarbonate concentrations before and during topiramate therapy were 26.8 +/- 2.9 mEq/L (range 21-36) and 21.7 +/- 3.6 mEq/L (range 13-29), respectively, with a mean difference of 5.1 (95% CI 3.7 to 6.5; p < 0.001). Twenty-six patients (48%) had low serum bicarbonate concentrations while on topiramate, with a mean concentration of 18.8 mEq/L (range 13-21). CONCLUSIONS: Topiramate was associated with metabolic acidosis in 48% of the patients studied, which did not result in clinically significant problems.
BACKGROUND:Topiramate is an antiepileptic medication with multiple pharmacologic effects, including inhibition of carbonic anhydrase activity. It is associated with metabolic acidosis in both children and adults. OBJECTIVE: To evaluate the incidence and magnitude of the effect of topiramate on serum bicarbonate concentrations in an adult population. METHODS: This was a retrospective cohort study. Data were evaluated to assess the relationship between serum bicarbonate concentrations before and during topiramate therapy. RESULTS: Fifty-four patients (40 females) with a mean age of 47.6 years (range 19-89) were included in the study. Mean +/- SD serum bicarbonate concentrations before and during topiramate therapy were 26.8 +/- 2.9 mEq/L (range 21-36) and 21.7 +/- 3.6 mEq/L (range 13-29), respectively, with a mean difference of 5.1 (95% CI 3.7 to 6.5; p < 0.001). Twenty-six patients (48%) had low serum bicarbonate concentrations while on topiramate, with a mean concentration of 18.8 mEq/L (range 13-21). CONCLUSIONS:Topiramate was associated with metabolic acidosis in 48% of the patients studied, which did not result in clinically significant problems.
Authors: Elahna Paul; Kerry D Conant; Irie E Dunne; Heidi H Pfeifer; David A Lyczkowski; Michael A Linshaw; Elizabeth A Thiele Journal: Epilepsy Res Date: 2010-05-13 Impact factor: 3.045
Authors: Valentina G Dell'Orto; Eva A Belotti; Barbara Goeggel-Simonetti; Giacomo D Simonetti; Gian Paolo Ramelli; Mario G Bianchetti; Sebastiano A G Lava Journal: Br J Clin Pharmacol Date: 2014-06 Impact factor: 4.335