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The use of Topamax is not recommended during pregnancy due to the risk of fetal harm, including a higher risk of cleft palate or cleft lip. Pregnancy registry data show that infants who are exposed to this medication in the womb have a higher risk of developing cleft palate or cleft lip, as well as a higher risk of being small for gestational age (SGA).

The use of Topamax during pregnancy may also lead to metabolic acidosis in pregnant women or fetuses, which may result in the fetus having difficulty tolerating labor. Women should discuss the risks of Topamax and pregnancy with their doctor if they normally take this medication or if they were planning to begin taking it.

Topamax and Breastfeeding

Topamax has been found in human breast milk, although whether or not it affects milk production is not known. There have been reports of infants who are nursing experiencing diarrhea and drowsiness when mothers take Topamax. The potential risks of using Topamax while breastfeeding should be discussed with a doctor.


Is it safe to take Topamax while pregnant?

Topamax is not recommended during pregnancy, since it may cause an increased risk of SGA and cleft palate or cleft lip. Women who take Topamax for seizures or migraines should talk to their doctor about potential risks to the fetus.

Does Topamax affect fertility?

More research is needed to understand the potential effects of Topamax on human fertility. A 2005 study involving female rats found that long-term exposure to this medication resulted in adverse effects on fertility.

How long should you be off Topamax before getting pregnant?

Women who are planning to become pregnant should talk to their doctor before stopping the use of this medication. Stopping medication suddenly may lead to an increased risk of seizures for those who take Topamax for epilepsy. Doctors can discuss other treatment options if needed or go over the potential risks to fetuses for women who may choose to continue taking Topamax during pregnancy.

Does Topamax cause birth control to not work?

Topamax may decrease the effectiveness of hormonal birth control. Women who use this type of birth control should discuss these effects with their doctor before taking Topamax.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

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