Lamotrigine/Estrogen-Containing Contraceptives Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Estrogen increases how quickly your body removes lamotrigine. Lamotrigine may increase how quickly your body removes the progestin part of your contraceptive medicine.
What might happen:
The amount of lamotrigine and progesterone in your blood may be lowered. You may have more seizures if you are taking lamotrigine for a seizure disorder. If you are taking an estrogen-containing contraceptive, you may experience break-through bleeding.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you notice any changes in your seizure frequency. Inform your doctor promptly if you have any changes in your menstrual cycle, such as break-through bleeding.If you are taking carbamazepine, phenytoin, phenobarbital, primidone, ritonavir, or rifampin, then your doctor will probably not need to adjust your lamotrigine dose.If you are not taking one of these medicines, then your doctor may need to adjust the dose of your lamotrigine if you start or stop taking your estrogen-containing contraceptive. Make sure that the doctor prescribing your lamotrigine knows if you start or stop taking estrogen-containing contraceptives. If you start an estrogen containing contraceptive your lamotrigine dose may need to be increased to maintain effectiveness. When you stop an estrogen containing contraceptive your lamotrigine dose may need be decreased to lower the risk for lamotrigine side effects.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Lamictal (lamotrigine) US prscribing information. GlaxoSmithKline October, 2020.
- 2.Dear Healthcare Professional, Subject: Important new safety information concerning the antiepileptic, LAMICTAL (lamotrigine). GlaxoSmithKline Canada September, 2004.
- 3.Sabers A, Ohman I, Christensen J, Tomson T. Oral contraceptives reduce lamotrigine plasma levels. Neurology 2003 Aug 26;61(4):570-1.
- 4.Sabers A, Buchholt JM, Uldall P, Hansen EL. Lamotrigine plasma levels reduced by oral contraceptives. Epilepsy Res 2001 Nov;47(1-2):151-4.
- 5.Reimers A, Helde G, Brodtkorb E. Ethinyl estradiol, not progestogens, reduces lamotrigine serum concentrations. Epilepsia 2005 Sep;46(9):1414-7.
- 6.Christensen J, Petrenaite V, Atterman J, Sidenius P, Ohman I, Tomson T, Sabers A. Oral contraceptives induce lamotrigine metabolism: evidence from a double-blind, placebo-controlled trial. Epilepsia 2007 Mar;48(3):484-9.
- 7.Contin M, Albani F, Ambrosetto G, Avoni P, Bisulli F, Riva R, Tinuper P, Baruzzi A. Variation in lamotrigine plasma concentrations with hormonal contraceptive monthly cycles in patients with epilepsy. Epilepsia 2006 Sep;47(9):1573-5.
- 8.Sidhu J, Job S, Singh S, Philipson R. The pharmacokinetic and pharmacodynamic consequences of the co-administration of lamotrigine and a combined oral contraceptive in healthy female subjects. Br J Clin Pharmacol 2006 Feb;61(2):191-9.
- 9.Centers for Disease Control and Prevention. U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Early Release 2010;59:1-86.
- 10.Department of Reproductive Health World Health Organization. Medical eligibility criteria for contraceptive use. Fifth Edition 2015.
- 11.Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit. Clinical guidance drug interactions with hormonal contraception. January, 2018.
Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.