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In contrast, internal hemorrhoids develop inside the rectum and are generally less painful but can cause bleeding, prolapse, and discomfort
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DRUG INTERACTIONS As with other medications, topiramate can interact with alcohol, marijuana and certain medications, including antiepileptic drugs, CNS depressants, oral contraceptives, lithium, other carbonic anhydrase inhibitors, hydrochlorothiazide, pioglitazone and amitriptyline
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Other limitations of these trials include the exclusion of sleepy patients with OSA, evaluation of composite rather than individual cardiovascular outcomes, and low PAP adherence [29]
