Topamax for Migraines, now I'm spotting...

I have combination migraines with daily cluster headaches. I have tried many treatments, but Topamax is the one that works best. Due to a recent flare-up in my headaches, I am taking this prescription again after 5 years of being off it.  I am currently taking 25mg at night. I have only been taking it for one week, but I've begun spotting.

I am also taking YAZ oral contraceptive. I have converns - is this an indication that my oral contraceptive is not working? Also, I am supposed to be increasing my dose to 50 mg per day, will the spotting get worse?  I'm wondering if I should wait one menstral cycle and see if the symptoms improve, or if maybe the combination of Topamax and Yaz is not going to work for me.

Please help! Thank you!

[DrNoopurMD]

Hi,

Thanks for writing in.
Topamax has been known to cause intermenstrual bleeding, spotting, heavy periods and hot flashes in women. Topamax interferes with the action of YAZ especially in doses like 200 mg per day and it is advisable not to take the two together and opt for another method of contraception like condoms and non hormonal IUDs.
Please do this only after discussing this in detail with your OBGYN.