Topiramate Digoxin

Topiramate may affect alcohol, amitriptyline, CNS depressants, lithium, oral contraceptives, digoxin, estrogens, hydantoins, metformin, risperidone, and valproic acid. 

Topiramate slightly impairs digoxin clearance (53), but the interaction is probably not clinically significant. 

Concomitant use of topiramate and digoxin has been shown to decrease the area under the concentration-time curve (ADC) for plasma digoxin by 12%, although the clinical relevance is unclear. - ... 

There is little evidence to suggest that carbamazepine interacts with digoxin, and topiramate causes only a small reduction in digoxin serum levels. Levetiracetam and tiagabine do not appear to interact with digoxin. 

Topiramate 100 mg twice daily for 9 days caused a small reduction in the serum digoxin levels of 12 healthy subjects. The maximum serum levels... 

Liao S, Palmer M Digoxin and topiramate drug interaction study in male volunteers. Pham Res (1993) 10 (10 Suppl), S405. 

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