http://www.medscape.com/viewarticle/466612

Medscape Alert
Topiramate Decreases Serum Bicarbonate


Medscape Staff ReportDec. 30, 2003 — Topiramate (Topamax) causes
hyperchloremic, non-anion gap metabolic acidosis (decreased serum bicarbonate),
Ortho-McNeil warned healthcare professionals in a letter mailed this month.
Measurement
of baseline and periodic serum bicarbonate during topiramate treatment is
recommended.According to the letter, the rate of occurrence of persistently
decreased serum bicarbonate ranged from 23% to 67% for patients treated with
topiramate and 1% to 10% for placebo in clinical trial. Incidence of markedly
low
serum bicarbonate ranged from 3% to 11% for topiramate and 0 to less than 1% for
placebo."Conditions or therapies that predispose to acidosis (such as renal
disease, severe respiratory disorders, status epilepticus, diarrhea, surgery,
ketogenic diet, or drugs) may be additive to the bicarbonate lowering effects of
topiramate," the letter added.MedWatch, the U.S. Food and Drug
Administration's safety information




MJH
"The Basil Book"
http://foxhillfarm.us/FireBasil











[Non-text portions of this message have been removed]