Topiramate and pregnancy
Topiramate has been linked to a small but increased risk of birth defects for your baby if you take it during pregnancy. Children born to mothers taking topiramate may have an increased risk of learning and development problems as they grow older.
If there's a chance you could become pregnant while taking topiramate, your doctor will enrol you on a pregnancy prevention programme.
If you think you might be pregnant and you're taking topiramate, contact your doctor or nurse as soon as possible.
If you have epilepsy and become pregnant, do not stop taking your medicine without talking to your doctor first. Epilepsy can become a lot worse if you suddenly stop your medicine.
Your doctor will review your treatment. It may be possible to change your epilepsy medicine to something that is safer in pregnancy. However, sometimes topiramate may be the most effective treatment, or the only treatment available, even if you're pregnant.
Your doctor will discuss what's best for you, based on your condition and the risks and benefits of topiramate.
There are many treatments for migraine that can be used during pregnancy. Your doctor should be able to offer you an alternative treatment to topiramate.
Topiramate and breastfeeding
If your doctor or health visitor says your baby is healthy, you can take topiramate while you're breastfeeding.
Topiramate passes into breast milk, and it can sometimes build up in your milk. This could make your baby sleepy or irritable, or make it difficult for them to feed. There has also been one report of it causing diarrhoea in a breastfed baby, but most babies will not have any side effects.
It's important to keep taking topiramate to keep you well. Breastfeeding will also benefit both you and your baby.
If you notice that your baby is not feeding as well as usual, or seems unusually sleepy or irritable, has diarrhoea or you have any other concerns about them, talk to your pharmacist, midwife, health visitor or doctor as soon as possible.
Topiramate and fertility
There's no evidence to suggest that taking topiramate causes fertility problems in either men or women.
However, speak to your doctor or specialist if you want to try to get pregnant, as they will want to review your treatment to see whether topiramate is still the right treatment for you. It's important to use contraception to avoid getting pregnant while waiting for a review by your doctor.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
- pregnant
- breastfeeding