Drug interactions
Hydrocortisone + Topiramate
Severity: Minor
Hydrocortisone and Topiramate: minor interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Topiramate is a weak CYP3A4 inducer at higher doses and might modestly lower hydrocortisone exposure. This is unlikely to be significant in most patients, though it could matter for adrenal replacement.
What this interaction means in plain words
Hydrocortisone and Topiramate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Hydrocortisone belongs to Endocrine; Topiramate belongs to Central Nervous System.
Why it happens
Dose-dependent weak CYP3A4 induction by topiramate may increase hydrocortisone metabolism.
What to do
No routine adjustment is needed. In adrenal insufficiency, monitor for symptoms of under-replacement when topiramate is started or increased.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone Major
Other interactions of Topiramate
Frequently asked questions
Can I take Hydrocortisone with Topiramate?
MediHelp rates the interaction as minor. Hydrocortisone and Topiramate have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Topiramate is a weak CYP3A4 inducer at higher doses and might modestly lower hydrocortisone exposure. This is unlikely to be significant in most patients, though it could matter for adrenal replacement.
How serious is the interaction between Hydrocortisone and Topiramate?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine adjustment is needed. In adrenal insufficiency, monitor for symptoms of under-replacement when topiramate is started or increased.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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