Topamax and Pregnancy

Doctor consultation

Pregnant women or women trying to conceive may need to know about Topamax and pregnancy if they take this medication. Read on to learn about the uses of this drug and its effect on pregnancy.

What Is Topamax?

Topamax is a brand name for topiramate, an anticonvulsant medication. The drug can augment anti-seizure medication for patients with epilepsy and it can be effective in preventing migraine headaches. It is not effective in treating migraines after they begin.

Patients normally take topiramate orally, either by taking capsules or by sprinkling the medication on food. Taking the medicine is quite simple, but the drug can have side effects. Some people taking topiramate experience little or no side effects, but what about Topamax and pregnancy?

Topamax and Pregnancy

Taking Topamax while pregnant is a tricky topic because the drug may harm an unborn baby. However, it isn't always prudent to stop taking the medication, especially if you are taking the anticonvulsant to treat seizures. Having a seizure during pregnancy can be harmful to both you and your developing baby.

What steps should you take if you are trying to conceive and what should you do if you think (or know) that you are pregnant?

Before Becoming Pregnant

Your doctor is very valuable in offering you the guidance that you need if you are taking Topamax, whether for seizures or migraines. If you are trying to conceive, it is imperative that you discuss your options with your doctor. After the consultation, you can create a plan of action.

Keep in mind that Topamax has drug interactions that can be very problematic for women taking certain types of birth control. Topiramate can cause birth control methods that use hormones, including birth control pills, patches, and rings, to become less effective. The decreased effectiveness can lead to pregnancy if you do not use another form of birth control.

Topamax During Pregnancy

Topamax is a Pregnancy Category C medication in the Food and Drug Administration's rating system. This means that studies have found the drug to cause harm to fetuses in animals, but no studies on humans exist. Animal studies found that the drug caused miscarriage, decreased weight in the fetus, and birth defects.

Since no clinical studies on human pregnancies have been completed, the effects on humans is unknown. However, the animal studies are cause enough for alarm and for great caution.

Adjunctive Therapy for Epilepsy

The issue becomes further complicated because Topamax is an adjunctive therapy for epilepsy and patients typically take this drug in addition to other anti-seizure medication. The other medications can cause birth defects in developing fetuses. Primary concerns are:

  • Congenital heart problems
  • Cleft palate
  • Neural tube defects
  • Skeletal abnormalities
  • Urinary tract defects

According to the Epilepsy Foundation, the risk of birth defects is four to eight percent when the mother is taking anti-seizure medication, compared to two to three percent in all babies.

Pregnancy and Topamax

Each woman is different, as is each pregnancy. It is critical to weigh the benefits and drawbacks of taking Topamax while you are pregnant. The first trimester is a very important period of fetal development, so contact your doctor when you have the very first signs of pregnancy.

Your doctor may keep you at the smallest dose possible; you may also be weaned from the drug or you may stay on your regular dose. This depends on your specific circumstances.

Topamax and Pregnancy