Valproate and Topiramate Interaction
Drug interaction information between Valproate and Topiramate.
Valproate and Topiramate have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Valproate 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
Taking these two medicines together can lead to a buildup of ammonia in your blood, which can cause brain-related problems.
FDA Label Information
diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement ( 7.2 ) • Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose ( 7.2 ) • Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with valproate ( 7.2 ) • Topiramate: Hyperammonemia and encephalopathy ( 5.9 , 7.3 ) 7.1 Effects of Co-Administered Drugs on Valproate Clearance Drugs that affect the level of expression of hepatic enzymes, particularly...
Valproate Also Interacts With
- Ranitidine major
- Cimetidine major
- Clarithromycin moderate
- Lidocaine Topical moderate
- Risperidone moderate
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 Valproate + 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?
Valproate has 41 labeled pairs on file vs Topiramate's 30. In the minor band specifically: Valproate has 36 (also Aspirin, Clonazepam, Amitriptyline, Acetaminophen); Topiramate has 27 (also Hydrochlorothiazide, Amitriptyline, Pioglitazone, Carbamazepine).
What mechanism field is on file for Valproate and Topiramate?
Taking these two medicines together can lead to a buildup of ammonia in your blood, which can cause brain-related problems.
Valproate carries more major-labeled pairs than Topiramate
SPL source-record counts only. This page's band is minor · classes on file: Valproate (Anticonvulsant / Mood Stabilizer); Topiramate (Anticonvulsant).
Valproate has 2 major-labeled pairs vs Topiramate's 0. This page itself is in the minor band, not the major band.
2 major · 3 moderate · 36 minor · 41 total
- Other minor peers for Valproate
- Aspirin
- Clonazepam
- Amitriptyline
- Acetaminophen
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.