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Lamotrigine and CHC — DFSRH MCQ

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HardPharmacology of contraceptionLamotrigine and CHCDFSRH

A 28-year-old with epilepsy controlled on lamotrigine requests a combined pill. She has no seizures for 2 years and no migraine. What is the most important counselling point?

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Correct answer: B — CHC can lower lamotrigine levels and affect seizure control

Combined hormonal contraception can reduce lamotrigine concentrations, potentially worsening seizure control, and lamotrigine levels may rise during hormone-free intervals. Lamotrigine is not a hepatic enzyme inducer that reduces CHC efficacy. Liaison with neurology and consideration of non-oestrogen methods are prudent.

Reference: FSRH Drug Interactions with Hormonal Contraception; BNF