Topiramate/Anticholinergics Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The combination of topiramate and anticholinergics may increase your risk of heat stroke, which can be serious.

What might happen:

Your temperature may become elevated and you may become dehydrated.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.Monitor for signs of heat stroke or dehydration, which may include skin feeling hot, little or no sweating, confusion, muscle cramps, fast heartbeat, fast breathing, dry mouth, urinating less than usual, or irritability. Maintain hydration and avoid exposure to excessive temperatures and strenuous physical exercise.In children, if any of the following occur, the child needs urgent medical attention: skin feels very hot with little or no sweating, confusion, muscle cramps, fast heartbeat, or fast breathing. Take the child to a cool, shaded place. Keep the child's skin cool with water. Give the child cold water to drink.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Topamax (topiramate) US prescribing information. Janssen Pharmaceuticals, Inc. May, 2023.
  • 2.Manivannan A, Kabbani D, Levine D. Use of multiple anticholinergic medications can predispose patients to severe non-exertional hyperthermia. BMJ Case Rep 2021 Mar 23;14(3):.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.