NutriStack
Topiramate and Vitamin D3, a synergy.
Topiramate can reduce vitamin D levels and increase kidney stone risk. Vitamin D supplementation helps prevent bone loss but the carbonic anhydrase inhibition may increase calcium stone risk.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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From the interaction database
What the row says.
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At a glance
- Substances
- Topiramate and Vitamin D3
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 4 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Topiramate can reduce vitamin D levels and increase kidney stone risk. Vitamin D supplementation helps prevent bone loss but the carbonic anhydrase inhibition may increase calcium stone risk.
Mechanism. Topiramate is a weak carbonic anhydrase inhibitor that increases urinary pH and citrate excretion, promoting calcium phosphate stones. It may also affect vitamin D metabolism through enzyme induction.
Recommendation. Monitor vitamin D levels. Supplement with 1000-2000 IU/day D3. Monitor calcium/renal function given topiramate's carbonic anhydrase inhibition and nephrolithiasis risk.
Sources (4)
- Valsamis HA et al. Antiepileptic drugs and bone metabolism. Nutr Metab (Lond). 2006;3:36. PMID 16956398
- Zhang Y, Fang F, Tang J et al.. Association between vitamin D supplementation and mortality: systematic review and meta-analysis.. BMJ. 2019. PMID 31405892
- Chang MC, Choo YJ. Effects of Whey Protein, Leucine, and Vitamin D Supplementation in Patients with Sarcopenia: A Systematic Review and Meta-Analysis.. Nutrients. 2023. PMID 36771225
- Fiamenghi VI, Mello ED. Vitamin D deficiency in children and adolescents with obesity: a meta-analysis.. Jornal de pediatria. 2021. PMID 33022267
Stack Score
How this pair moves the number.
Effect on the composite score
If both Topiramate and Vitamin D3 are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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