An interaction between lamotrigine and combined oral contraceptives

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Pharmacotherapy

An interaction between lamotrigine and combined oral contraceptives

By Linda Bryant, Penny Clark and Leanne Te Karu

Tuesday 15 April 2025, 12:25 AM

Combined oral contraceptives can decrease the serum concentration of lamotrigine by 40 to 60 per cent [Image: Reproductive Health Supplies Coalition on Unsplash]

Pharmacist prescribers Linda Bryant, Penny Clark and Leanne Te Karu review a potentially significant drug–drug interaction between the antiepileptic lamotrigine and combined oral contraceptives

Key points, Combined oral contraceptives reduce lamotrigine serum levels, which can lead to decreased seizure control in the active hormone phase and/or increased, Pract Green w Pale Yellow

Medicines and Therapies

Women's Health

Endocrinology

References

Gaffield ME, Culwell KR, Lee CR. The use of hormonal contraception among women taking anticonvulsant therapy. Contraception 2011;83(1):16–29.
Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol 2006;61(3):246–55.
Reddy DS. Clinical pharmacokinetic interactions between antiepileptic drugs and hormonal contraceptives. Expert Rev Clin Pharmacol 2010;3(2):183–92.
Reimers A, Helde G, Brodtkorb E. Ethinyl estradiol, not progestogens, reduces lamotrigine serum concentrations. Epilepsia 2005;46(9):1414–17.
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;61(2):191–99.
The Faculty of Sexual and Reproductive Healthcare. Clinical Guidance: Drug Interactions with Hormonal Contraception. May 2022.

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