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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Stop Topomax In Pregnancy?

I am 25 wks pregnant and used to be on Topomax. I stopped in my 2nd week of pregnancy and would like to know if it is O.K. to go back on it in my last trimester. I have terrible migraines and Fiorcet just does not help. What are the risks in these last few months?
Tue, 13 May 2014
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OBGYN 's  Response
Hello and welcome,

Topomax has the drug topiramate.

This drug is category D meaning that it is contraindicated in pregnancy. It is known to be associated with birth defects like facial and skull abnormalities.

However in our experience we have seen that for teratogenic drugs ( drugs causing malformations in babies) not all cases exposed show the toxic effects. As you have stopped it early, the baby may not have beedn exposed for any effects to occur. As you have already taken in during the first two weeks, I suggest to get a TIFFA scan done now to rule out any anomalies.

Then further decisions can be taken after the effects of scan are available.

Also considering the toxic profile of the drug I will not recommend you to use it in the third trimester.

As of now, just get a TIFFA scan done and then further decisions can be taken.

Hope this was helpful.
Thanks for asking us.
Feel free for further queries.
Dr Madhuri Bagde
Consultant Ob gyn.
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Is It Safe To Stop Topomax In Pregnancy?

Hello and welcome, Topomax has the drug topiramate. This drug is category D meaning that it is contraindicated in pregnancy. It is known to be associated with birth defects like facial and skull abnormalities. However in our experience we have seen that for teratogenic drugs ( drugs causing malformations in babies) not all cases exposed show the toxic effects. As you have stopped it early, the baby may not have beedn exposed for any effects to occur. As you have already taken in during the first two weeks, I suggest to get a TIFFA scan done now to rule out any anomalies. Then further decisions can be taken after the effects of scan are available. Also considering the toxic profile of the drug I will not recommend you to use it in the third trimester. As of now, just get a TIFFA scan done and then further decisions can be taken. Hope this was helpful. Thanks for asking us. Feel free for further queries. Dr Madhuri Bagde Consultant Ob gyn.