Lancashire and South Cumbria
Formulary
 
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4 Central nervous system
04-08-01 Topiramate

Topiramate
Formulary

Tablets 25mg,50mg, 100mg, 200mg
Sprinkle capsules 15mg, 25mg, 50mg

Epilepsy.

Topiramate oral suspension - Restricted for paediatric use only, when sprinkle capsules are unsuitable. Prescribers should be cautious when selecting the strength of suspension as multiple strengths are available.

Topiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. This follows a review by the MHRA which concluded that the use of topiramate during pregnancy is associated with significant harm to the unborn child. Harms included a higher risk of congenital malformation, low birth weight and a potential increased risk of intellectual disability, autistic spectrum disorder and attention deficit hyperactivity disorder in children of mothers taking topiramate during pregnancy.

Link  MHRA: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review
Link  MHRA: Antiepileptic drugs: updated advice on switching between different manufacturers products
Link  MHRA: Antiepileptics: risk of suicidal thoughts and behaviour
Link  MHRA: Topiramate (Topamax): introduction of new safety measures, including a Pregnancy Prevention Programme
Link  MHRA: Topiramate (Topamax): start of safety review triggered by a study reporting an increased risk of neurodevelopmental disabilities in children with prenatal exposure

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