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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For High Blood Pressure And Seizure Disorder

My blood pressure today was 130/100. I have a seizure disorder and am on Topamax, lamactil and klonopil. I just recently starting taking Norvasc. I started Jan 5th. I feel nauseated all the time too. Are they related? I thought my blood pressure would go down by now.
Fri, 26 Jun 2015
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Cardiologist 's  Response
Hello!

Thank you for asking on HCM!

Regarding your concern, your symptoms may be related to norvasc intake (nausea has been seen in up to 3% of patients using this drug) or a possible interaction between topiramate and norvasc.

Topiramate can decrease the levels of norvasc (by acting in its degradation in the liver), causing a lower effect of norvasc in controlling the blood pressure.

Topiramate has been shown increase the blood pressure in 1-2 % of the patients. It can also cause kidney dysfunction and stones, which can induce a secondary hypertension.

I recommend you to perform a routine blood test, kidney and liver function tests, thyroid hormone levels blood electrolytes and an ECG.
An ambulatory 24 hours BP monitoring would be helpful to have more information on your blood pressure during the day.

I would recommend changing into another antihypertensive drug (hydrochlorothiazide or an ACE inhibitor).

I would also recommend you to consult with the neurologist to consider the possibility to lower topiramate dose or switch into another antiepileptic drug.

Hope to have been helpful!

Greetings! Dr. Iliri
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Suggest Treatment For High Blood Pressure And Seizure Disorder

Hello! Thank you for asking on HCM! Regarding your concern, your symptoms may be related to norvasc intake (nausea has been seen in up to 3% of patients using this drug) or a possible interaction between topiramate and norvasc. Topiramate can decrease the levels of norvasc (by acting in its degradation in the liver), causing a lower effect of norvasc in controlling the blood pressure. Topiramate has been shown increase the blood pressure in 1-2 % of the patients. It can also cause kidney dysfunction and stones, which can induce a secondary hypertension. I recommend you to perform a routine blood test, kidney and liver function tests, thyroid hormone levels blood electrolytes and an ECG. An ambulatory 24 hours BP monitoring would be helpful to have more information on your blood pressure during the day. I would recommend changing into another antihypertensive drug (hydrochlorothiazide or an ACE inhibitor). I would also recommend you to consult with the neurologist to consider the possibility to lower topiramate dose or switch into another antiepileptic drug. Hope to have been helpful! Greetings! Dr. Iliri