Epilepsy And Oral Contraceptives

Some antiepilepsy drugs (carbamazepine, phenytoin, barbituates, topiramate, oxcarbazepine) induce steroid metabolising enzymes and can cause hormonal contraception to fail. Patients who are taking these drugs need a higher dose of oestrogen (least 50 micrograms /day) if they wish to continue on the pill, although this does not guarantee complete protection from pregnancy with the associated risks to the fetus. Lamotrigine and sodium valproate are not enzyme inducers and their use is not reason to alter the dose of oral contraceptive.

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