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Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD): [12] This study found blood concentrations in breastfed infants of mothers taking carbamazepine, oxcarbazepine, valproate, levetiracetam, and topiramate were quite low, especially in relationship to the mother's level and what the fetal level would have been ...
As is the case for all antiepileptic drugs, it is advisable not to suddenly discontinue topiramate as there is a theoretical risk of rebound seizures. Some studies have attributed loss of appetite and upper respiratory tract infection to topiramate, but studies have concluded their adverse events are not difficult to tolerate for most individuals.
Use of anticonvulsant medications should be carefully monitored during use in pregnancy. [94] For example, since the first trimester is the most susceptible period for fetal development, planning a routine antiepileptic drug dose that is safer for the first trimester could be beneficial to prevent pregnancy complications. [95]
However, not all of them are safe to use during pregnancy. One of the components of bismuth subsalicylate is salicylate, which is a component that crosses the placenta. Due to this, there is an increased risk for intrauterine growth retardation, fetal hemorrhage, and maternal hemorrhage within organogenesis and in the second/third trimester. [ 12 ]
[5] [19] The Essential Medicines List (EML) was updated in July 2023 to its 23rd edition. This list contains 1200 recommendations for 591 drugs and 103 therapeutic equivalents. [20] A separate list for children up to 12 years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007 and is in its 9th ...
[8] [7] Use during pregnancy may result in harm to the fetus. [9] Primidone is an anticonvulsant of the barbiturate class; [7] however, its long-term effect in raising the seizure threshold is likely due to its active metabolite, phenobarbital. [10] The drug’s other active metabolite is phenylethylmalonamide (PEMA).
[3] [6] While use during pregnancy may harm the baby, use may be less risky than having a seizure. [1] [8] Use is not recommended during breastfeeding. [1] In those with an allergy to carbamazepine there is a 25% risk of problems with oxcarbazepine. [3] How it works is not entirely clear. [5]
The pregnancy category of a medication is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. It does not include any risks conferred by pharmaceutical agents or their metabolites in breast milk. Every drug has specific information listed in its product literature.