Drug interactions
Perampanel + Topiramate
Severity: Moderate
Perampanel and Topiramate: moderate 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 can lower perampanel levels, with reported reductions of roughly one fifth, possibly reducing seizure control. The effect is generally modest and manageable.
What this interaction means in plain words
Perampanel and Topiramate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Perampanel belongs to Central Nervous System; Topiramate belongs to Central Nervous System.
Why it happens
Topiramate induces CYP3A4-mediated metabolism of perampanel.
What to do
Monitor seizure control when topiramate is added or withdrawn, and titrate perampanel according to response and tolerability.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Topiramate
Other interactions of Perampanel
- Apalutamide + Perampanel Major
- Enzalutamide + Perampanel Major
- Alprazolam + Perampanel Moderate
- Amisulpride + Perampanel Moderate
- Amobarbital + Perampanel Moderate
- Asenapine + Perampanel Moderate
Frequently asked questions
Can I take Perampanel with Topiramate?
MediHelp rates the interaction as moderate. Perampanel and Topiramate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Topiramate can lower perampanel levels, with reported reductions of roughly one fifth, possibly reducing seizure control. The effect is generally modest and manageable.
How serious is the interaction between Perampanel and Topiramate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor seizure control when topiramate is added or withdrawn, and titrate perampanel according to response and tolerability.
What other medicines interact with Topiramate?
MediHelp also lists interactions of Topiramate with, for example, Benzhydrocodone / acetaminophen, Buprenorphine long-acting, Buprenorphine subdermal implant. The full list is on the Topiramate page.
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