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Contraception - Management
How does epilepsy influence choice?
- Women with a history of epilepsy who are not taking anticonvulsants
- All methods can be used without restriction.
- Women taking anticonvulsants that do not induce liver enzymes (i.e. gabapentin, levetiracetam, valproate, and vigabatrin)
- All methods can be used without restriction, except that sterilization should be undertaken with caution and seizures should be adequately controlled.
- Women taking anticonvulsants that induce liver enzymes (phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine)
- Methods that can be used without restriction: depot medroxyprogesterone acetate, copper intrauterine devices, the levonorgestrel-releasing intrauterine system, barrier methods, and natural family planning methods.
- Methods that can generally be used (benefits generally outweigh the risks): progestogen-only implant, depot norethisterone enantate.
- Sterilization can be done with caution.
- Methods that should not usually be used (risks usually outweigh the benefits): combined oral contraceptive, combined contraceptive patch, combined contraceptive vaginal ring, and progestogen-only pill.
- If combined oral contraceptives are chosen, dose adjustment may be needed. For more information about dose adjustment, see Liver enzyme-inducing drugs.
- Women taking lamotrigine
- Methods that can be used without restriction: progestogen-only pills, injectables and implants, copper intrauterine devices, the levonorgestrel-releasing intrauterine system, barrier methods, and natural family planning methods.
- Methods that should not usually be used (risks usually outweigh the benefits): combined oral contraceptives, combined contraceptive patch, combined contraceptive vaginal ring.
- If combined oral contraception is chosen, dose adjustment may be needed. For more information about dose adjustment, see Lamotrigine and Drug interactions.
In depth
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