Topiramate and Lithium Interaction
Drug interaction information between Topiramate and Lithium.
Topiramate and Lithium have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Topiramate and Lithium. 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
Using high doses of topiramate can lead to higher levels of lithium in your bloodstream.
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. 7.7 Lithium An increase in systemic exposure of lithium following topiramate doses of up to 600 mg/day can occur. Lithium levels...
Topiramate Also Interacts With
- Zonisamide moderate
- Alogliptin moderate
- Ertugliflozin moderate
- Hydrochlorothiazide minor
- Amitriptyline minor
Lithium Also Interacts With
- Amlodipine/Benazepril major
- Risperidone major
- Amiloride moderate
- Amiodarone moderate
- Amlodipine/Valsartan moderate
Frequently Asked Questions
What SPL severity band is on file for Topiramate + Lithium?
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?
Lithium has 90 labeled pairs on file vs Topiramate's 30. In the minor band specifically: Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Pioglitazone, Carbamazepine); Lithium has 65 (also Aripiprazole, Asenapine, Canagliflozin, Candesartan).
What mechanism field is on file for Topiramate and Lithium?
Using high doses of topiramate can lead to higher levels of lithium in your bloodstream.
Lithium carries more major-labeled pairs than Topiramate
SPL source-record counts only. This page's band is minor · classes on file: Topiramate (Anticonvulsant); Lithium (Mood Stabilizer).
Lithium has 2 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
- Carbamazepine
2 major · 23 moderate · 65 minor · 90 total
- Other minor peers for Lithium
- Aripiprazole
- Asenapine
- Canagliflozin
- Candesartan
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.