Abstract
Background:
Topiramate (TPM) is commonly used for migraine prophylaxis; nonetheless, it is linked to nephrotoxicity, which mostly results from oxidative stress and inflammatory mechanisms.

Aim:
This study aimed to assess the preventive effects of gallic acid (GA) and furosemide (Lasix) against renal damage caused by TPM in rats.

Methods:
Sixty male albino rats were categorized into six groups: control, TPM-only, TPM + Lasix, Lasix-only, TPM + GA, and GA-only. The investigation lasted 60 days, evaluating renal function, oxidative stress indicators, and histological and immunohistochemical alterations.

Results:
The TPM-treated group exhibited considerable renal impairment, as indicated by increased levels of creatinine, urea, blood urea nitrogen (BUN), and interleukin (IL)-6, as well as reduced activity of antioxidant enzymes (catalase (CAT), superoxide dismutase (SOD)). Histopathological examination revealed tubular necrosis and inflammation, whilst immunohistochemistry results showed elevated expression of caspase3 and IL-6. The co-administration of GA or Lasix mitigated these effects. The TPM+GA group exhibited improved kidney function, less oxidative stress, and enhanced histological structure, underscoring GA's powerful antioxidant and anti-inflammatory characteristics. Likewise, Lasix exerted protective effects by alleviating TPM-induced kidney injury.

Conclusion:
These data highlight the therapeutic efficacy of GA and Lasix against TPM-induced nephrotoxicity, indicating their clinical relevance in addressing drug-induced kidney damage.

Key words: TPM, Gallic acid, Lasix, Renal damage, Anti-inflammatory, Antioxidant