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Topiramate pregnancy safety — GPhC CRA MCQ

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HardAdverse Drug Reactions and Drug SafetyTopiramate pregnancy safetyGPhC CRA

A woman taking topiramate for migraine prevention says she is planning pregnancy and asks whether she can continue until she conceives. What monitoring is required?

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Correct answer: D — Refer promptly to the prescriber for pregnancy-prevention and alternative treatment review

Topiramate is associated with fetal harm and requires careful pregnancy-prevention and treatment review. Patients should not be left to continue until conception without prescriber involvement. Folic acid may be advised in some contexts but does not remove teratogenic risk. Migraine prevention alternatives should be considered by the prescriber.

Reference: MHRA Drug Safety Update; BNF