Metformin and Topiramate Interaction
Drug interaction information between Metformin and Topiramate.
Metformin and Topiramate have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Metformin and Topiramate. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Topiramate can change how your body manages acid levels in the blood. This may increase the risk of a rare but dangerous side effect from metformin called lactic acidosis.
FDA Label Information
Examples: Topiramate, zonisamide, acetazolamide or dichlorphenamide.
Metformin Also Interacts With
- Bictegravir/Emtricitabine/Tenofovir moderate
- Dolutegravir/Lamivudine moderate
- Empagliflozin moderate
- Empagliflozin/Linagliptin moderate
- Ertugliflozin moderate
Topiramate Also Interacts With
- Zonisamide moderate
- Alogliptin moderate
- Ertugliflozin moderate
- Hydrochlorothiazide minor
- Amitriptyline minor
Frequently Asked Questions
What SPL severity band is on file for Metformin + Topiramate?
Compiled FDA labeling labels this pair minor. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Topiramate has 30 labeled pairs on file vs Metformin's 27. In the minor band specifically: Metformin has 17 (also Dolutegravir, Ranolazine, Cimetidine, Phenytoin); Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Pioglitazone, Carbamazepine).
What mechanism field is on file for Metformin and Topiramate?
Topiramate can change how your body manages acid levels in the blood. This may increase the risk of a rare but dangerous side effect from metformin called lactic acidosis.
Topiramate's labeled portfolio outnumbers Metformin
SPL source-record counts only. This page's band is minor · classes on file: Metformin (Biguanide); Topiramate (Anticonvulsant).
0 major · 10 moderate · 17 minor · 27 total
- Other minor peers for Metformin
- Dolutegravir
- Ranolazine
- Cimetidine
- Phenytoin
0 major · 3 moderate · 27 minor · 30 total
- Other minor peers for Topiramate
- Hydrochlorothiazide
- Amitriptyline
- Pioglitazone
- Carbamazepine
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.