In the United States, the Food and Drug Administration (FDA) assigns each medication to a Pregnancy Category according to whether it has been proven to be harmful in pregnancy. Trileptal is listed in Pregnancy Category C. This indicates that caution is advised, but the benefits of the medicine may outweigh the potential risks. Studies in animals have shown some harm to the baby, but there haven't been any good studies of results in women.

Talk to your doctor or another health professional if you are pregnant or plan to become pregnant. We don't yet have enough information to be able to estimate the risk of various types of birth defects that might occur if Topamax is taken during pregnancy. We also don't know enough to compare the risk with Topamax to the risk with other seizure medicines. The risk of birth defects is generally higher for women who take more than one seizure medication and for women with a family history of birth defects.

Women who are capable of becoming pregnant should take at least 400 mcg (0.4 mg) of folic acid (folate) daily to help prevent a type of birth defect called a neural tube defect. (The best-known of these is spina bifida, in which the spinal cord is not completely enclosed.) Women at high risk, such as those who have already had a baby with this kind of defect, should take 4000 mcg (4 mg) daily, beginning before they become pregnant.

There is limited information on how much Topamax is passed through breast milk. The potential for serious side effects in nursing infants is unknown. If you want to breastfeed your baby, check with your doctor about what seizure medicine would be best for you.

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