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epilepsy and contraception
Women who are sexually active and taking antiepileptic medicine should be made aware that some medications
can interfere with the workings of the oral contraceptive pill. Those who are seeking family planning advice
should let the doctor, nurse or midwife know about the medication being taken and appropriate advice can be
Antiepileptic drugs, which lessen the effect of the oral contraceptive, are the enzyme inducing drugs which
increases the rate at which the liver breaks down the Pill. These include:-
The effectiveness of the oral contraceptive is enhanced, when any of the above drugs are being taken, by
taking a prescribed dose of oestrogen because sufficient oestrogen prevents ovulation. An increase in dosage
of “The Pill” will not be effective for contraception if an enzyme inducing drug is being taken.
A tell tale sign that the dose of oestrogen is not sufficient for reliable contraception is breakthrough bleeding and
such an event should be discussed with a specialist.
Non enzyme inducing antiepileptic drugs do not have any effect on the oral contraceptive pill and include:-
Barrier methods of contraception such as condoms, diaphragm, cap and sponge and the newly developed
Mirena coil are not affected by any of the antiepileptic drugs.
There is a small risk of having a seizure when an intrauterine device is being fitted so it is important that the
person fitting the device should be aware of the epilepsy.
Progestogen Injections are available to women who have epilepsy but, as with the oral contraceptive pill for
those taking enzyme inducing drugs, there is the possibility of the drugs lessening the effect of the injection and
resulting in an unwanted pregnancy. Those who use the injections for contraception and are taking enzyme
inducing drugs should discuss the matter with the prescribing doctor with a view to slightly increasing the
frequency of administering the injection. The current recommendation is for administration every 10 weeks. The ‘rhythm’ and ‘persona’ methods of contraception rely on detection of hormonal changes relating to monthly
ovulation. Since antiepileptic medication can cause hormonal changes neither of these methods is
Male companions will also need to be aware of the risk of an unplanned pregnancy due to the effects of a
partner’s antiepileptic medicine and should share in the decision making process as to which method of
contraception to adopt having listened to advice from the experts.
The use of the ‘morning after pill’ is available for women on antiepileptic medicine and, although there is no
evidence to support the view that a slightly increased dose should be given to those taking enzyme inducing
drugs, it is recommend that the slightly increased dose should be taken.
Mersey Region Epilepsy Association is a Registered Charity No. 504366
JAPI - DIPSI Guidelines Gestational Diabetes Mellitus – Guidelines* V Seshiah, AK Das, Balaji V, Shashank R Joshi, MN Parikh, Sunil Gupta For Diabetes In Pregnancy Study Group (DIPSI)+ Abstract The Diabetes In Pregnancy Study group India (DIPSI) is reporting practice guidelines for GDM in the Indian environment. Due to high prevalence, screening is essential for all Indian pregnan
DESARROLLO DE UN MÉTODO ANALÍTICO BASADO EN LA EXTRACCIÓN CON DISOLVENTES PRESURIZADOS Y ANÁLISIS CROMATOGRÁFICO PARA LA DETERMINACIÓN DE RESÍDUOS DE ANTIBIÓTICOS FLUOROQUINOLONAS EN HUEVOS S. Herranz, M.C. Moreno-Bondi and M.D. Marazuela* Departamento de Química Analítica, Facultad de CC. Químicas. Universidad Complutense de Madrid, E-28040 Madrid, Spain. * Contacto: El empleo ru