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Should not be used in individuals with a history of heart attack or unstable heart disease

This question arises for patients prescribed topiramate (Topamax) for epilepsy or migraine prophylaxis alongside semaglutide (Wegovy) for weight management

Obesity is an important risk factor for various metabolic disorders, including insulin resistance and type 2 diabetes 2 , atherosclerosis 3 , cardiovascular disease 4 , and chronic kidney disease 5 , and can cause oxidative stress 6, 7 , endoplasmic reticulum (ER) stress 8, 9 , and mitochondrial dysfunction 10, 11

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