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Oral contraceptive and lamotrigine — GPhC CRA MCQ

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HardDrug InteractionsOral contraceptive and lamotrigineGPhC CRA

A 22-year-old woman stable on lamotrigine for epilepsy plans to start a combined oral contraceptive. She asks whether it affects her seizure medicine. What is the most important interaction to flag?

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Correct answer: D — Combined hormonal contraception may reduce lamotrigine concentrations

Oestrogen-containing contraception can reduce lamotrigine concentrations and may affect seizure control. Lamotrigine levels can also change during hormone-free intervals. Specialist advice is appropriate before starting or changing contraception. The interaction is clinically important for seizure stability.

Reference: BNF; FSRH