Pitomate Use In Pregnancy & Lactation

Pregnancy: Pregnancy category: D.
Topiramate was found to cross the placenta and can cause fetal harm when administered to pregnant women. Use of the drug during the first trimester of pregnancy is associated with an increased risk of the development of oral clefts. Topiramate has demonstrated selective development toxicity, including teratogenicity and embryotoxicity in animals. Metabolic acidosis may be induced by Topiramate and may result in adversed effects and fetal death. Pregnant women and their newborns should be monitored for metabolic acidosis. Maternal serum concentration may decrease during the second and third trimesters of pregnancy therefore therapeutic drug monitoring should be considered in pregnant women who require therapy. Topiramate should be used during pregnancy only when the potential benefits outweigh the possible risks.
Lactation: Topiramate is excreted into breast milk. Infant plasma concentrations of Topiramate have been reported as 10% to 20% of the maternal plasma concentration. Use with caution in a nursing woman.