A 26-year-old woman has been prescribed Topiramate (Topamax) for management of a seizure disorder. The health care provider prescribing the medication will include which information in the medication education provided to the patient?

A. The medication will be replaced with valproic acid (Depakote) if pregnancy occurs: Valproic acid is highly teratogenic and is generally avoided in pregnancy due to a significant risk of neural tube defects, making this an unsafe substitution. B. The medication alters the menstrual cycle making conception very unlikely: Topiramate does not reliably suppress ovulation or alter the menstrual cycle to prevent pregnancy, so conception can still occur while taking this medication. C. The medication can decrease the effectiveness of oral contraception: Topiramate can induce hepatic enzymes and reduce estrogen levels, which lowers the effectiveness of combined oral contraceptives and increases the risk of unintended pregnancy. D. The medication can cause congenital malformations in a fetus: While topiramate is associated with teratogenic risks, especially oral clefts, the most critical patient education point is its interaction with hormonal contraceptives that may lead to unplanned pregnancy.