What the FDA labels say about taking them together
Lithium and topiramate
Topiramate's FDA label of June 1, 2026 names lithium in its drug interactions section; the lithium labels PlainMeds reads (4) do not name topiramate. The topiramate label: “Monitor lithium levels if lithium is used with high-dose EPRONTIA.”
Check it at the source: the lithium FDA label on DailyMed (effective December 23, 2025, Glenmark Pharmaceuticals Inc., USA); the topiramate FDA label on DailyMed (effective June 1, 2026, Sun Pharmaceutical Industries, Inc.).
What does the lithium label say about topiramate?
Lithium's label (effective December 23, 2025) and its 3 other brand-application labels do not name topiramate in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Lithium Carbonate), Glenmark Pharmaceuticals Inc., USA, effective December 23, 2025 (SPL set 63b3790f-a9b5-47f4-bae1-ddf8b43c13c1), via openFDA; the full label on DailyMed
What does the topiramate label say about lithium?
Topiramate label, drug interactionsMonitor lithium levels if lithium is used with high-dose topiramate
Qudexy Xr label (Upsher-Smith Laboratories, LLC, September 3, 2026), drug interactionsDRUG INTERACTIONS Oral contraceptives: decreased contraceptive efficacy and increased breakthrough bleeding, especially at doses greater than 200 mg per day ( 7.4 ) Monitor lithium levels if lithium is used with high-dose QUDEXY XR
Source: FDA drug label (Qudexy Xr, NDA205122), Upsher-Smith Laboratories, LLC, effective September 3, 2026 (SPL set 46f54677-3a22-4c38-9b92-923020164e15), via openFDA
Source: FDA drug label (Eprontia, NDA214679), Azurity Pharmaceuticals, Inc., effective November 13, 2025 (SPL set e2a4df59-fead-4a01-9021-9eda02c48010), via openFDA
Source: FDA drug label (Trokendi Xr, NDA201635), Supernus Pharmaceuticals, Inc., effective March 20, 2026 (SPL set 2dc7957e-a3e5-46bb-aa66-f3250f872f5e), via openFDA
Source: FDA drug label (Topiramate), Sun Pharmaceutical Industries, Inc., effective June 1, 2026 (SPL set 3c909a53-ae66-4b28-a741-b60bb25a69cf), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Lithium | Topiramate | |
|---|---|---|
| Labeled for | Bipolar disorder | Seizures and epilepsy, Migraine |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.104 per capsule 300 mg capsule | $0.0567 per tablet 100 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once