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Topiramate-induced refractory hypokalemia
Girish N Nadkarni1, Narender Annapureddy, Ira S Meisels
1Department of Medicine, Division of Nephrology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY.
American Journal of Therapeutics
|October 19, 2012
Summary
Topiramate, a neuromodulator, can cause kidney stones and potassium wasting. This case highlights severe, refractory hypokalemia in a patient with comorbidities treated with topiramate for seizures.
Area of Science:
- Neurology
- Nephrology
Background:
- Topiramate is a neuromodulator with carbonic anhydrase inhibitor properties.
- It is associated with renal calculi and potential renal potassium wasting.
Observation:
- A patient with severe comorbidities presented with refractory hypokalemia.
- The patient was undergoing treatment with topiramate for seizure management.
Findings:
- This case demonstrates a clinically significant instance of renal potassium wasting.
- Refractory hypokalemia occurred despite the generally considered insignificant nature of this side effect.
Implications:
- Clinicians should monitor electrolyte levels, particularly potassium, in patients on topiramate.
- Severe comorbidities may increase the risk of significant adverse events associated with topiramate treatment.
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