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Thread: Topiramate 25mg dosage and breast feeding

  1. #1
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    Topiramate 25mg dosage and breast feeding

    I take 25mg of Topiramate for seizure migraines (stopped taking during pregnancy) and I would very much like to breast feed. However nobody will tell me if it is safe enough, they just say don't breast feed then you're not putting your baby at any risk. Would you tend to agree?

  2. #2
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    Dear Indiec1981,

    Topiramate (Topamax) may be used during breastfeeding with close monitoring. The amount transferred into milk is relatively high, however, there have been no reports of adverse effects in the breastfed infant. The drug levels in two infants were 10 to 20 percent of maternal blood levels. Due to the fact that the blood levels found in breastfeeding infants were significantly less than in maternal blood, the risk of using this product in breastfeeding mothers is probably acceptable. Close observation for sedation is advised. The time topiramate is most concentrated in the breastmilk would be 1.5 to 4 hours after your dose so avoid breastfeeding during that time to minimize the amount of drug your infant is exposed to. The typical dose is 200 mg twice daily so you are on a very low dose. Let me know if you have further questions.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center
    Last edited by cpride; 04-18-2012 at 03:11 PM.

  3. #3
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    Hello i just started topiramate 25 mg just 1..yesterday i took it at 10pm and my baby would not sleep . She needed my milk because she is teething (14months) I gave it to her at 4 am and then the next night i took it at 1219am and fed her at 459 am i putting her at risk . She has not weened but she has trouble sleeping and she is off the bottle and the sippy cup doesnt help(put her to sleep ) because she is teething


    [QUOTE=cpride;1201]Dear Indiec1981,

    Topiramate (Topamax) may be used during breastfeeding with close monitoring. The amount transferred into milk is relatively high, however, there have been no reports of adverse effects in the breastfed infant. The drug levels in two infants were 10 to 20 percent of maternal blood levels. Due to the fact that the blood levels found in breastfeeding infants were significantly less than in maternal blood, the risk of using this product in breastfeeding mothers is probably acceptable. Close observation for sedation is advised. The time topiramate is most concentrated in the breastmilk would be 1.5 to 4 hours after your dose so avoid breastfeeding during that time to minimize the amount of drug your infant is exposed to. The typical dose is 200 mg twice daily so you are on a very low dose. Let me know if you have further questions.
    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center[/QUOTE]

  4. #4
    Administrator
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    Justice:

    The normal dose of topiramate ranges from 25 mg per day up to 200 mg/day. So you can see your dose is the lowest. In addition, the typical side effect of topiramate is sedation, not insomnia. I think your infant is not sleeping due to teething. I'd check with your pediatrician, but I'll bet its the teething problem.

    Tom Hale Ph.D.

  5. #5
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    Hi - has any more research been conducted? I'm breast feeding with terrible migraines. I would like to go back on a small dosage of 25-50mgs. Is sedation the only side effect to look for? Are evenings after his last feeding the best time to take it? Will it impact my supply?

  6. #6
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    Dear JI2011

    The normal dose of Topiramate (Topamax) ranges from 25 mg/day up to 200 mg/day, you are on a low dose. Despite the amount transferred into milk being relatively high, there have been no reports of adverse effects in the breastfed infant. However, close observation for sedation is advised. The time topiramate is most concentrated in the breastmilk would be 1.5 to 4 hours after your dose so avoid breastfeeding during that time to minimize the amount of drug your infant is exposed to. If your infant sleeps throughout the night, then that would be the best time to take it. We do not have any evidence that topiramate may impact your milk supply.

    Hope this helps, for further questions please contact us at the InfantRisk Center 806-352-2519.

    Tassneem Abdel Karim MD
    InfantRisk Center

  7. #7
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    Thank you for the*informative*posts.

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