Topiramate and Carbamazepine Interaction
Drug interaction information between Topiramate and Carbamazepine.
Topiramate and Carbamazepine have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Topiramate and Carbamazepine. 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
Carbamazepine makes your body get rid of topiramate faster, which lowers the amount of medicine in your blood.
FDA Label Information
7 DRUG INTERACTIONS Oral contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg/day ( 7.4 ) Monitor lithium levels if lithium is used with high-dose topiramate ( 7.7 ) 7.1 Antiepileptic Drugs Concomitant administration of phenytoin or carbamazepine with topiramate resulted in a clinically significant decrease in plasma concentrations of topiramate when compared to topiramate given alone.
Topiramate Also Interacts With
- Zonisamide moderate
- Alogliptin moderate
- Ertugliflozin moderate
- Hydrochlorothiazide minor
- Amitriptyline minor
Carbamazepine Also Interacts With
- Nirmatrelvir/Ritonavir major
- Ranolazine major
- Risperidone major
- Lithium moderate
- Apixaban moderate
Frequently Asked Questions
What SPL severity band is on file for Topiramate + Carbamazepine?
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?
Carbamazepine has 129 labeled pairs on file vs Topiramate's 30. In the minor band specifically: Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Pioglitazone, Lithium); Carbamazepine has 110 (also Omeprazole, Ibuprofen, Citalopram, Amitriptyline).
What mechanism field is on file for Topiramate and Carbamazepine?
Carbamazepine makes your body get rid of topiramate faster, which lowers the amount of medicine in your blood.
Carbamazepine carries more major-labeled pairs than Topiramate
SPL source-record counts only. This page's band is minor · classes on file: Topiramate (Anticonvulsant); Carbamazepine (Anticonvulsant).
Carbamazepine has 3 major-labeled pairs vs Topiramate's 0. This page itself is in the minor band, not the major band.
0 major · 3 moderate · 27 minor · 30 total
- Other minor peers for Topiramate
- Hydrochlorothiazide
- Amitriptyline
- Pioglitazone
- Lithium
3 major · 16 moderate · 110 minor · 129 total
- Other minor peers for Carbamazepine
- Omeprazole
- Ibuprofen
- Citalopram
- Amitriptyline
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.