Topiramate and Pioglitazone Interaction
Drug interaction information between Topiramate and Pioglitazone.
Topiramate and Pioglitazone have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Topiramate and Pioglitazone. 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 amount of pioglitazone in your body, which might make your diabetes treatment less effective.
FDA Label Information
7.6 Pioglitazone A decrease in the exposure of pioglitazone and its active metabolites were noted with the concurrent use of pioglitazone and topiramate in a clinical trial. The clinical relevance of these observations is unknown; however, when topiramate is added to pioglitazone therapy or pioglitazone is added to topiramate therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state [see Clinical Pharmacology ( 12.3 )] .
Topiramate Also Interacts With
- Zonisamide moderate
- Alogliptin moderate
- Ertugliflozin moderate
- Hydrochlorothiazide minor
- Amitriptyline minor
Pioglitazone Also Interacts With
- Clarithromycin major
- Rifampin minor
- Gemfibrozil minor
- Abiraterone minor
- Dapagliflozin minor
Frequently Asked Questions
What SPL severity band is on file for Topiramate + Pioglitazone?
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 Pioglitazone's 10. In the minor band specifically: Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Carbamazepine, Lithium); Pioglitazone has 9 (also Rifampin, Gemfibrozil, Abiraterone, Dapagliflozin).
What mechanism field is on file for Topiramate and Pioglitazone?
Topiramate can lower the amount of pioglitazone in your body, which might make your diabetes treatment less effective.
Pioglitazone carries more major-labeled pairs than Topiramate
SPL source-record counts only. This page's band is minor · classes on file: Topiramate (Anticonvulsant); Pioglitazone (Thiazolidinedione).
Pioglitazone has 1 major-labeled pair 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
- Carbamazepine
- Lithium
1 major · 0 moderate · 9 minor · 10 total
- Other minor peers for Pioglitazone
- Rifampin
- Gemfibrozil
- Abiraterone
- Dapagliflozin
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.