NC Neuropsych

Lamictal and oral contraception

“While there are no absolutes in this business, it does seem that there is no clinically significant change in birth control pill blood levels and effectiveness when combined with Lamictal. The studies are limited, of course, but this is certainly encouraging. In the studies that were done, the women who were taking the combination did not show any clinical or hormonal signs of ovulation (supression of ovulation is the point of birth control pills). There is, however, a very slight effect of birth control pills on Lamictal concentrations (this is news to me!). Co-administration of Lamictal with birth control pills will result in slightly lower blood levels of Lamictal. During the one week placebo pill period of birth control pills, blood levels of Lamictal will actually go up. Slightly. There can be some potential clinical relevance to this. If you increase the dose of Lamictal at the same time that the patient is entering the blank-pill section of her birth control pills, she will be receiving a larger increase in the Lamictal than was intended. Since the most concerning side effect of the Lamictal (rash) is correlated with giving too much too fast, it may be prudent to avoid Lamictal increases during that last week of the pills.
–Dan Hartman, MD”
http://thesidewalkpsychiatrist.wordpress.com/2007/06/30/combining-lamictal-with-birth-control-pills/

If you might become pregnant while taking lamotrigine, your doctor may want you to take folic acid supplements.
It is especially important that your health care professional know if you are taking any of the following:
• Carbamazepine (e.g., Tegretol) or
• Phenobarbital (e.g., Luminal) or
• Phenytoin (e.g., Dilantin) or
• Primidone (e.g., Mysoline) or
• Valproic acid (e.g., Depakote)—These medicines may increase or decrease the blood levels of lamotrigine, which may increase the chance of unwanted effects; your doctor may need to change the dose of either these medicines or lamotrigine
• Oral contraceptives (e.g., birth control pills) or
• Other female hormone therapy—Your doctor may need to adjust your dose of lamotrigine. Also, using birth control pills with lamotrigine may make the birth control pills not work as well.
http://www.drugs.com/cons/lamictal.html