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Contraception - Management
Interactions with lamotrigine: what should be done?
- If the woman is already receiving lamotrigine:
- If she wishes to start a combined oral contraceptive (COC), advise her:
- That a COC containing a minimum of 30 micrograms of ethinylestradiol should be used.
- That seizure control may worsen.
- That the maintenance dose of lamotrigine may need to be increased as much as two-fold, according to clinical response.
- If she wishes to stop a COC, advise her:
- That adverse effects associated with lamotrigine can increase.
- That the maintenance dose of lamotrigine may need to be decreased by as much as 50%, according to clinical response.
- If the woman is already using a COC and wishes to initiate lamotrigine:
- The usual escalation regimen for lamotrigine is recommended.
In depth
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