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    Kidney stones 5 times more common in those given 15 mg of phentermine plus 92 mg of Topamax


    Posted by .(JavaScript must be enabled to view this email address)
    Tuesday, April 26, 2011 11:03 am Email this article
    Kidney stones were 5 times more common in people given 15 mg of phentermine plus 92 mg of Topamax (topiramate) than those given either a placebo or 7.5 mg of phentermine plus 46 mg of Topamax (topiramate) according to a new study from Duke University in Durham, North Carolina, USA. Kidney Stones

    Kidney Stones in 11 out of 994 people given 15 mg of phentermine plus 92 mg of Topamax vs only 2 out of 993 given a placebo

    There were 11 cases of kidney stones out of 994 people given 15 mg of phentermine plus 92 mg of Topamax (topiramate) (1%), including three serious adverse events—although they do not say exactly what the serious adverse events were in these patients with kidney stones—compared to only 2 cases of kidney stones out of 993 people given a placebo (0.2%) and only one case out of 498 given 7.5 mg of phentermine plus 46 mg of Topamax (topiramate).

     

    What caused the kidney stones?

    Topamax lowers potassium and bicarbonate levels

    The increased risk of kidney stones may have been due to the fact that Topamax lowers both potassium, and more importantly, bicarbonate levels in the blood.

    They found that potassium levels were below the lower limit of 3·5 mmol per liter in 5.3 percent of patients given 15 mg of phentermine plus 92 mg of Topamax (topiramate) versus 3.6 percent of those given 7.5 mg of phentermine plus 46 mg of Topamax (topiramate) versus 1.1 percent of patients given the placebo.

    “Inhibition of carbonic anhydrase by topiramate [Topamax] presumably accounts for the paraesthesia and taste alteration, decreased concentrations of serum bicarbonate and potassium, and risk of nephrolithiasis [kidney stones],” the authors noted.

     

    How to reduce the risk of kidney stones

    Potassium Citrate or potassium bicarbonate lowered the risk of kidney stones 12-fold according to 1993 study

    A supplement of potassium citrate reduced the number of kidney stones 12-fold over the next 3 years, from 1.2 stones per year to 0.1 stones per year in people who had a history of kidney stones according to a 1993 study (Barcelo et al, 1993).

    Forty-two percent (42%) of patients (13 of 31) given potassium citrate had NO kidney stones over the next 3 years.

    Potassium citrate is metabolized to potassium bicarbonate in the body, and both reduce urinary excretion of calcium, therefore, I assume potassium bicarbonate would work just as well at reducing kidney stones.

    I’ve taken potassium bicarbonate for 11 years, since 2000, to reduce blood pressure. It has lots of benefits.

    In 58% of patients (18 of 31) given potassium citrate, kidney stones were reduced 12-fold over the next 3 years, from 1.2 per year to 0.1 per year

    Forty-two percent (42%) of patients (13 of 31) given potassium citrate had NO kidney stones over the next 3 years.

    This compared to those given a placebo which had
    - 1.1 stones per year while receiving the placebo vs 1.1 per year prior to the study, and
    - 20% of patients (4 of 20) had no stones over the next 3 years.

     

    Subjects

    Subjects: 2487 overweight and obese patients

    The study wad done at 93 centers in the US and involved 2487 overweight and obese patients who were 18- to 70-years-old, with an average age of 51.

    Seventy percent (70%) of subjects were women.

     

    Body Weight

    Average body weight: 226 lbs; BMI 36-37

    The average body weight of the subjects was 226 pounds.

    The average body mass index (BMI) was 36-37.

    REFERENCE

    Gadde K, Allison D, Ryan D, Peterson C, Troupin B, Schwiers M, Day W. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (conquer): A randomised, placebo-controlled, phase 3 trial. Lancet. 2011 Apr 16, 377(9774):1341-52.

    AUTHOR’S CONTACT INFORMATION

    Dr Kishore M Gadde
    Obesity Clinical Trials Programme
    Box 3292
    Duke University Medical Center
    Durham, NC 27710, USA
    .(JavaScript must be enabled to view this email address)

    OTHER REFERENCE

    Barcelo P, Wuhl O, Servitge E, Rousaud A, Pak C. Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol. 1993 Dec, 150(6):1761-64.

     

    Other articles about Phentermine plus Topamax

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    Robert Skversky, MD on Dr. Oz talking about Phentermine plus Topamax for weight loss, Part 3

    Robert Skversky, MD on Dr. Oz talking about Phentermine plus Topamax for weight loss, Part 4

    Robert Skversky, MD on Dr. Oz talking about Phentermine plus Topamax for weight loss, Part 5

    Topamax (topiramate) caused average weight gain of 5.3 lbs in six months in migraine suffers

    Woman loses 40 lbs on Topamax with Robert Skversky, MD

    Woman loses 115 lbs on phentermine, Topamax and Lexapro with Robert Skversky, MD

    How I use Topamax for weight loss by Robert Skversky, MD

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    High-dose Qnexa: 15 mg Phentermine plus 92 mg Topamax causes weight loss of 10.4% vs 1.8% w/placebo

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    High-dose Qnexa: 15 mg Phentermine plus 92 mg Topamax causes weight loss of 11% vs 1.6% w/placebo

    Low-dose Qnexa: 3.75 mg Phentermine plus 23 mg Topamax causes weight loss of 5.1% vs 1.6% w/placebo

    Qnexa (Phentermine/Topamax) side effects dry mouth, tingling, constipation, altered taste, insomnia

    Topamax (topiramate) used by 50% of weight loss doctors surveyed

    Qnexa (Phentermine/Topamax) side effects dry mouth, tingling, constipation, altered taste, insomnia

    Topamax and Zonegran can increase the risk of suicidal thoughts and behaviors according to the FDA

    Topamax caused weight loss of 15.8 lbs in 59% of patients who gained weight on psychotropic drugs

    43-year-old man loses 50 lbs in 4 months on phentermine plus Topamax (topiramate) - update

    43-year-old man loses 44 lbs in 3 months on phentermine plus Topamax (topiramate)

    Topamax caused psychosis in brother & sister; 75 mg twice a day in one, 25 mg twice a day the other

    Type 2 Diabetics given Topamax lost 13.2 lbs vs 5.5 lbs for those given a placebo

     

    Other articles about Phentermine plus Topamax Posted Later

    Other articles about Phentermine plus Topamax posted after this article

    Other articles posted after this article can be found here.

    Articles on the same subject can be found here:


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