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Just found out I am pregnant and I am wondering how safe it is that I am on the low dose of 25mg of topamax once a day. I also have been taking a prenatal and fish oil to avoid deficiencies.
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Pumpkins:
Topiramate(Topamax) has a rather poor tract record in pregnancy. Numerous birth defects have been reported, but I'm sure this is dose related. An increased risk of cleft palate, etc have been reported.
In humans, topiramate may induce liver enzymes that metabolize Vitamin K, thus may lead to increased risk of hemorrhagic disease of the newborn. Pregnant women consuming this drug should probably be supplemented with up to 10 mg Vitamin K per day, in the last trimester. It is recommended to start folic acid supplementation (4 mg/day) prior to and during pregnancy.
Both normal and rare abnormal pregnancy outcomes have been identified in human case reports and case series after topiramate exposure during pregnancy. The FDA recently changed the pregnancy category of topiramate to a D due to an increased risk of development of cleft lip and/or cleft palate (oral clefts) in infants born to women treated with topiramate during pregnancy.
I'd suggest you have a discussion with your ob/gyn and try to find a more suitable alternative. If you decide to continue with this dose, then increase your vitamin K and folic acid dosage.
Tom Hale Ph.D.
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