The Basics
What is Topiramate?
Used alone or with other medications to treat primary generalized tonic-clonic seizures and partial onset seizures.
Brand names for Topiramate
Topamax
How Topiramate is classified
Anticonvulsants, Neuroprotective Agents
Topiramate During Pregnancy
Topiramate pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Topiramate while pregnant
N/A
Taking Topiramate While Breastfeeding
What are recommendations for lactation if you're taking Topiramate?
Limited information indicates that maternal doses of topiramate up to 200 mg daily produce relatively low levels in infant serum. Monitor the infant for diarrhea, drowsiness, irritability, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs.
Maternal / infant drug levels
Limited information indicates that maternal doses of topiramate up to 200 mg daily produce relatively low levels in infant serum. Monitor the infant for diarrhea, drowsiness, irritability, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs.
Possible effects of Topiramate on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Topiramate
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ohman I, Vitols S, Luef G et al. Topiramate kinetics during delivery, lactation, and in the neonate: preliminary observations. Epilepsia. 2002;43:1157-60. PMID: 12366729
2. Froscher W, Jurges U. [Topiramate used during breast feeding]. Aktuel Neurol. 2006;33:215-7.
3. Westergren T, Hjelmeland K, Kristoffersen B et al. Probable topiramate-induced diarrhea in a 2-month-old breast-fed child – A case report. Epilepsy Behav Case Report. 2014;2:22-3. PMID: 25667861
4. Ohman I, Luef G, Tomson T. Topiramate kinetics during lactation. Epilepsia. 2007;48 (Suppl 7):156-7. Abstract p417. DOI: doi:10.1111/j.1528-1167.2006.01370_8.x
5. Johannessen SI, Helde G, Brodtkorb E. Levetiracetam concentrations in serum and in breast milk at birth and during lactation. Epilepsia. 2005;46:775-7. PMID: 15857447
6. Gentile S. Topiramate in pregnancy and breastfeeding. Clin Drug Investig. 2009;29:139-41. PMID: 19133709
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
