Metformin/Pioglitazone and Topiramate Interaction
Drug interaction information between Metformin/Pioglitazone and Topiramate.
Metformin/Pioglitazone and Topiramate have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Metformin/Pioglitazone 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 lower the levels of pioglitazone in your body, which might make it work less effectively. It can also cause a change in your blood's acid levels.
FDA Label Information
( 7.6 ) Topiramate may decrease pioglitazone concentrations. 7.3 Carbonic Anhydrase Inhibitors Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) frequently causes a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis. 7.8 Topiramate A decrease in the exposure of pioglitazone and its active metabolites were noted with concomitant administration of pioglitazone and topiramate [see Clinical Pharmacology (12.3) ] .
Metformin/Pioglitazone Also Interacts With
- Dolutegravir moderate
- Ranolazine moderate
- Cimetidine moderate
- Metformin minor
- Pioglitazone minor
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/Pioglitazone + 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/Pioglitazone's 10. In the minor band specifically: Metformin/Pioglitazone has 7 (also Metformin, Pioglitazone, Rifampin, Gemfibrozil); Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Pioglitazone, Carbamazepine).
What mechanism field is on file for Metformin/Pioglitazone and Topiramate?
Topiramate can lower the levels of pioglitazone in your body, which might make it work less effectively. It can also cause a change in your blood's acid levels.
Topiramate's labeled portfolio outnumbers Metformin/Pioglitazone
SPL source-record counts only. This page's band is minor · classes on file: Metformin/Pioglitazone (Biguanide / TZD Combination); Topiramate (Anticonvulsant).
0 major · 3 moderate · 7 minor · 10 total
- Other minor peers for Metformin/Pioglitazone
- Metformin
- Pioglitazone
- Rifampin
- Gemfibrozil
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.