Pregnancy, breastfeeding and fertility while taking carbamazepine

Carbamazepine and pregnancy

Carbamazepine has been linked to an increased risk of problems for your baby if you take it in pregnancy.

You'll usually only be advised to take carbamazepine if your doctor thinks the benefits of the medicine outweigh the risks.

If you take carbamazepine for epilepsy, it's important that this is controlled during pregnancy, as seizures can harm you and your baby. If you become pregnant, keep taking carbamazepine, but talk to your doctor straight away. It is likely that you will need to be seen in a specialist epilepsy clinic, and they may want to change your medicine.

If you're trying to get pregnant or have become pregnant while taking carbamazepine, it's recommended you take a high dose of folic acid (5mg a day). You can get this from your doctor or midwife.

Ideally, it's best to take high dose folic acid for 3 months before you start trying to get pregnant and for the first 12 weeks of pregnancy. Do not worry if you have not taken it before you get pregnant, but start taking it as soon as possible once you know that you are pregnant. It helps your baby to grow normally.

Your baby may need extra monitoring for a few days after they're born. This is because they can sometimes have withdrawal symptoms from carbamazepine.

Carbamazepine and breastfeeding

If your doctor or health visitor says your baby is healthy, it's OK to take carbamazepine while you're breastfeeding.

Carbamazepine does pass into breast milk. Most babies do not get any side effects, but some babies might be more sleepy or not feed as well as usual. Taking other medicines while you're taking carbamazepine may mean your baby gets side effects, although this is still rare.

It's important to keep taking carbamazepine to keep you well. Do not stop taking it without talking to your doctor. Breastfeeding will also benefit both you and your baby.

Talk to your doctor, midwife or health visitor as soon as possible if:

• your baby is not feeding as well as usual
• your baby seems unusually sleepy
• your baby has an upset stomach
• the whites or your baby's eyes turn yellow, or their skin turns yellow (this may be less noticeable on brown or black skin) – this could be a sign of jaundice
• you have any other concerns about your baby

Carbamazepine and fertility

Carbamazepine does not affect female fertility, however, there have been rare reports of problems with male fertility.

Speak to your doctor if you have any concerns.

For more information about how carbamazepine can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.