Pharmacist Steve--Medication Side Effects Question

[sandybeaches]

Steve,
I take 20 mg oxycontin q daily, 0.25 xanax bid (prn basis), 800 mg skelaxin bid or tid prn, 50mg topamax bid and 10 mg Lortab bid prn (maybe 1-2 daily). For the last week or so, I have felt like someone has kicked me in my kidneys from the back, but don't show any symptoms of a kidney infection, bladder, or UTI.

I do have the nasty habit of drinking too many soft drinks and have stopped those and am pushing water to flush my kidneys. Polyscystic kidney disease runs in my family, my mom lost a kidney to it and so has a first cousin. My cousin's mom passed away from it. I do have one kidney that is slow to empty as seen on a nuclear renal scan several years ago.

I am wondering if any of these meds that I am on are possibly causing me any negative problems with my kidneys. I am calling my GP to get in and going to ask for some type of scan or ultrasound to make sure that all is well. The last blood work that I had a couple of months ago, my creatinine, BUN, and other levels were in normal levels.

I did have a recent scare with high liver enzymes (do not drink alcohol and gallbladder is out) and was taken off of Topamax and Mobic for 3 months
until enzymes returned to normal and resumed Topamax but not Mobic. Enzymes remain normal now.

Thanks for any help you can give me.

Pam

[Pharmacist.steve]

It could be a kidney stone... since many drugs are excreted via the kidneys and your disease could flare up/advance at any point of time.. it is really hard to come to any real educated guess as to what may be the underlying problem

[sandybeaches]

Thanks for your suggestion..I will be calling my GP first thing in the morning.

Pam

[lobelsteve]

Topamax and kidney stones.

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a697012.html

[Kira]

I agree on the Topamax/kidney stones thing. I didn't get kidney stones with it, but I did get hypercalciuria (high calcium in the urine) and a few other things changed/worsened with how my kidneys process electrolytes (mostly bicarb, potassium). It got better after stopping Topamax, though. Not everyone gets these problems, but they were common enough to make it into a "black box" warning on the prescribing info.

Would be worth asking your doc about, at least.

http://www.rxlist.com/cgi/generic/topiram_wcp.htm

The "black box" warning is talking about metabolic acidosis, but that is the underlying cause of the other electrolyte problems and kidney stone issues with topamax. When they talk (several paragraphs down) about nephrolithiasis and nephrocalcinosis ("Chronic, untreated metabolic acidosis may increase the risk for nephrolithiasis (http://www.rxlist.com/script/main/art.asp?articlekey=6806) or nephrocalcinosis (http://www.rxlist.com/script/main/art.asp?articlekey=17594), and may also result in osteomalacia (http://www.rxlist.com/script/main/art.asp?articlekey=4680) (referred to as rickets (http://www.rxlist.com/script/main/art.asp?articlekey=6714) in pediatric patients) and/or osteoporosis (http://www.rxlist.com/script/main/art.asp?articlekey=4686) with an increased risk for fractures."), they are referring to kidney stones (nephrolithiasis) and calcification of the kidneys (nephrocalcinosis). It happens because the drug affects how you excrete different electrolytes in your urine...

[sandybeaches]

Thanks Dr. Steve and Kira for the information. I am seeing my doctor soon,,, and have begun the weaning process of the Topamax already.

Pam

[ErinENj]

Pam: I don't take any of those meds so I'm not sure what the problem could be. But I did want to say that I hope you get it figured out asap and that the solution is an easy one! Feel better soon!! :D

[sandybeaches]

Erin,
Thanks for the sweet note. You are always so good at giving support to everyone on here. I am pulling for your graduation and your trip...I hope it all goes well for you!!!

Pam

[Mark N]

Pam, are you feeling any better today? I hope you were able to go to the doctor if you woke up and still felt the keidney pain.

[BrokenBladder]

Hi Pam I'm checking in on you also. Please let us know how you're feeling!!

Take Care,
Lisa

[sandybeaches]

Hi guys,
My docs office was closed for Good Friday yesterday (yep they still do that down here in the south) so I didn't get to see him. The pain is still there, but maybe not quite so bad or either I am learning to tolerate it.

I will see him either on Monday or Tuesday....I just really hope that it is from the Topamax and not the kidney disease that is in my family. I have never shown symptoms from it before, but am hitting 50 now and my first cousin had her transplant at 50. So, thanks for asking and keep your fingers crossed for me!!!
Pam

[Pharmacist.steve]

www.chronicpainresourcecenter.com/misc/topamaxwarning.pdf

Here is a warning - in a non-medical publication - about Topamax.. I couldn't get the image into this post .. so I uploaded to my website and here is the link. Past the issue of kidney stones... I wonder where the Calcium is coming from - like from your bones!!!!

[sandybeaches]

I worry about that too, Pharmacist Steve....I already take Boniva because of osteopenia. Needless to say, Topamax will no longer be part of my meds!!

Thanks for the info!
Pam