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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by karen_kay on May 2, 2007, at 7:16:51
anyone know anything about it?
a urologist said (while treating my husband) 'oh, you're on topamax? i'll treat you for stones then later.'
anyone know anythign about it?
Posted by linkadge on May 2, 2007, at 10:27:06
In reply to topamax and stones?, posted by karen_kay on May 2, 2007, at 7:16:51
What a stupid thing to say, (or at least a stupid way to say it).
I don't know if there is a connection or not. If there is, you think she could have given the information in a more polite way.
Linkadge
Posted by Phillipa on May 2, 2007, at 11:47:10
In reply to Re: topamax and stones?, posted by linkadge on May 2, 2007, at 10:27:06
Goggle Nickengland and topamax and kidney stones he had a bout with them. I remember. Love Phillipa
Posted by Larry Hoover on May 2, 2007, at 13:50:56
In reply to topamax and stones?, posted by karen_kay on May 2, 2007, at 7:16:51
> anyone know anything about it?
>
> a urologist said (while treating my husband) 'oh, you're on topamax? i'll treat you for stones then later.'
>
> anyone know anythign about it?The drug monograph gives quite a detailed view of the problem, under "Metabolic Acidosis". http://www.rxlist.com/cgi/generic/topiram_wcp.htm
The effect is dose-dependent. It also can be easily monitored by a physician, by doing blood tests for serum bicarbonate levels. Abnormal bloodwork will precede actual kidney stone formation. Untreated, or ignored, the condition can also lead to osteomalacia or osteoporosis.
"If metabolic acidosis develops and persists, consideration should be given to reducing the dose or discontinuing topiramate (using dose tapering). If the decision is made to continue patients on topiramate in the face of persistent acidosis, alkali treatment should be considered."
So, anyone on Topamax should be getting regular and routine bloodwork done, at least until early vulnerability to this side effect is known, with followups to catch late-developing instances.
Lar
Posted by karen_kay on May 2, 2007, at 22:17:34
In reply to Re: topamax and stones? » karen_kay, posted by Larry Hoover on May 2, 2007, at 13:50:56
now, since i've had the blood work done in the past, came back fine, should i consider that i'm fine now as well. (figure i'll ask her about it next apt anyway. i'm anything but petite and figure i'll have no problems with osteowhatever in the future)
i remember from last time i was taking it, when they (they who?) first started with the blood tests.
i found it odd that my pdoc hasn't said a thing about bloodwork, but i'm not too excited about paying for it either (stupid insurance isn't too keen on paying for much at this point).
Posted by Bob on May 3, 2007, at 0:18:49
In reply to topamax and stones?, posted by karen_kay on May 2, 2007, at 7:16:51
I took Topomax a few years ago (2001 or 2002?) and developed kidney stones. I had 4 or 5 stones total, and a few of them were large. I passes one of them and it sucked. Then I had to get the ultrasound treatment to break up the rest of them (lithotripsy, I believe it's called). Then my doctor ordered me off the Topomax immediately. It wasn't a good time, as I also had profoundly negative psychological effects from the med eventually.
I just posted here to let you know that the kidney stone problem can happen, but I think many people are totally unaffected by it - I was unlucky there.
Posted by karen_kay on May 3, 2007, at 5:50:40
In reply to Re: topamax and stones?, posted by Bob on May 3, 2007, at 0:18:49
other than klonopin, it's my drug of choice (and the only ms that's worked for me to date).
poor bob's <place where stones sit and pass>, (sorry on a fine line here, and mister bob is back, you know!).
darn it, i've got blood work to schedule....
Posted by Larry Hoover on May 3, 2007, at 7:36:31
In reply to Re: topamax and stones? » Larry Hoover, posted by karen_kay on May 2, 2007, at 22:17:34
> now, since i've had the blood work done in the past, came back fine, should i consider that i'm fine now as well. (figure i'll ask her about it next apt anyway. i'm anything but petite and figure i'll have no problems with osteowhatever in the future)
The monograph says it usually shows itself early in treatment, but not always. The urologist's comment does suggest that late cases are not uncommon. I'm not going to suggest how often monitoring tests should be done. That's up to your doctor, and should be based on the actual blood work results. Interpretation should not be limited to single test results, but also to trends over time.
> i found it odd that my pdoc hasn't said a thing about bloodwork,
I think the word is negligent.
> but i'm not too excited about paying for it either (stupid insurance isn't too keen on paying for much at this point).
I don't know what the true price is for peace of mind, but I hope it's not prohibitive.
Lar
Posted by karen_kay on May 3, 2007, at 8:13:03
In reply to Re: topamax and stones? » karen_kay, posted by Larry Hoover on May 3, 2007, at 7:36:31
previous conversation:
> i found it odd that my pdoc hasn't said a thing about bloodwork,
I think the word is negligent.
i suppose you'd be right. i couldn't think of the right word though.
i'll check into it when i see her again.
thanks lar,
kk
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