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  • Migraines

    I suffer from migraines and normally take 150mg per day of topamax during my pregnancy I didn’t take anything it was horrible. Now that I’m nursing I’d like to know the transfer rate to baby and what I should look for as far as problems go

  • #2

    Topamax (topiramate) is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 24.6-55.6% of your dose. "Topiramate may be used during breastfeeding with close monitoring. The amount transferred into milk is relatively high. There has also been one case report of an infant with persistent diarrhea. Plasma levels in two infants were 10-20% of maternal plasma levels. Topiramate has become increasingly popular due to its lower adverse effect profile in relation to other treatment options. Due to the fact that the plasma levels found in breastfeeding infants were significantly less than in maternal plasma, the risk of using this product in breastfeeding mothers is probably acceptable." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). Monitor your infant for sedation or irritability, not waking to feed/poor feeding, diarrhea, weight loss.

    Sandra Lovato R.N.
    InfantRisk Center