1,4-butanediol - Topamax (Topiramate) Interaction

Interaction Details

Topiramate is classified as belonging to the following category: Cns Depressants

Theoretically, concomitant use of 1,4-butanediol with CNS depressants may potentiate respiratory and CNS depression.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of CNS depressants with GHB may cause serious CNS and respiratory depression.

Interaction Rating

Likelihood of Occurrence

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.

References

• Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8.
• Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.

Interaction Details

Topiramate is classified as belonging to the following category: Anticonvulsants

Theoretically, concomitant use of 1,4-butanediol with certain anticonvulsants may potentiate respiratory and central nervous system (CNS) depression or increase the risk of seizures.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of anticonvulsants that have sedative effects with GHB may cause serious CNS and respiratory depression. GHB might also reduce the effectiveness of anticonvulsants since it also can cause seizures.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8.
• Carotenuto A, De Feo V, Fattorusso E, et al. The flavonoids of Allium ursinum. Phytochem 1996;41:531-6.
• Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.

Interaction Details

Topiramate is classified as belonging to the following category: Topiramate (Topamax)

Concomitant use of 1,4-butanediol with topiramate may potentiate adverse effects.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of topiramate with GHB may increases blood levels of GHB. In one case report, a patient regularly taking GHB 4.5 grams twice nightly was hospitalized after initiating treatment with topiramate 25 mg daily. Symptoms included confusion, muscle jerking, miosis, and coma. Plasma levels of GHB were 2.5-fold higher than when GHB was given alone. Potential mechanisms might include decreased GHB breakdown, increased absorption, and/or increased activity.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Weiss T, Müller D, Marti I, Happold C, Russmann S. Gamma-hydroxybutyrate (GHB) and topiramate--clinically relevant drug interaction suggested by a case of coma and increased plasma GHB concentration. Eur J Clin Pharmacol. 2013 May;69(5):1193-4.

Topiramate Overview

• Topiramate is used alone or with other medications to treat certain types of seizures including primary generalized tonic-clonic seizures (formerly known as a grand mal seizure; seizure that involves the entire body) and partial onset seizures (seizures that involve only one part of the brain). Topiramate is also used with other medications to control seizures in people who have Lennox-Gastaut syndrome (a disorder that causes seizures and developmental delays). Topiramate is also used to prevent migraine headaches but not to relieve the pain of migraine headaches when they occur. Topiramate is in a class of medications called anticonvulsants. It works by decreasing abnormal excitement in the brain.

1,4-butanediol - More Interactions

1,4-butanediol interacts with 268 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.