Topiramate (Topamax): New Safety Measures Including a Pregnancy Prevention Programme

2 July, 2024

The UK government has introduced new safety measures for topiramate (Topamax), a medication used to treat epilepsy and migraines. These measures include a Pregnancy Prevention Programme (PPP) due to the high risk of birth defects associated with topiramate exposure during pregnancy. This article outlines the key components of the new safety measures and provides guidance for healthcare professionals on implementing the PPP to ensure the safety of women of childbearing potential who are prescribed topiramate.


Topiramate (Topamax) is a widely used medication for epilepsy and migraine prevention. Due to the significant risk of congenital malformations when taken during pregnancy, new safety measures, including a Pregnancy Prevention Programme (PPP), have been introduced to protect women of childbearing potential.

Key Safety Measures

  • Pregnancy Prevention Programme (PPP): A mandatory programme for all women of childbearing potential prescribed topiramate.
  • Risk Acknowledgement Form: Patients must sign a form acknowledging the risks associated with topiramate use during pregnancy.
  • Regular Pregnancy Tests: Frequent pregnancy testing to ensure that women are not pregnant while taking topiramate.
  • Contraceptive Measures: Women must use effective contraception throughout treatment and for a specified period after stopping the medication.

Healthcare Professional Guidance

  • Patient Education: Healthcare professionals must provide comprehensive education on the risks of topiramate during pregnancy and the importance of adhering to the PPP.
  • Counselling: Ongoing counselling and support for patients to ensure understanding and compliance with the PPP.
  • Monitoring: Regular monitoring and follow-up appointments to reinforce the importance of pregnancy prevention measures.


The introduction of new safety measures, including the Pregnancy Prevention Programme, aims to mitigate the risks associated with topiramate use during pregnancy. Healthcare professionals play a crucial role in educating and supporting patients to ensure these measures are effectively implemented.


Read more: Topiramate (Topamax): introduction of new safety measures, including a Pregnancy Prevention Programme – GOV.UK (

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