Epilepsy and Contraception

Authored by , Reviewed by Prof Cathy Jackson | Last edited | Meets Patient’s editorial guidelines

It's best to seek advice from a doctor or epilepsy nurse when you are planning to start using contraception or when considering starting a family.

Some anti-epilepsy medicines have a side-effect of increasing the speed in which some contraceptive pills and injections are processed by the liver. These medicines are known as liver enzyme inducers, as they speed up certain processes in the liver cells.

The following anti-epilepsy medicines are liver enzyme inducers:

The other anti-epilepsy medicines, including sodium valproatelamotrigine and ethosuximide, are not liver enzyme inducers. If you are taking an anti-epilepsy medicine which is not a liver enzyme inducer then your contraceptive choices, doses, etc, are usually the same as for any other women (although see below about lamotrigine).

However, if you are taking an anti-epilepsy medicine that is a liver enzyme inducer, the following is recommended:

Using either barrier methods of contraception or having any type of coil inserted (including the intrauterine system) are usually the most suitable forms of contraception to consider if you are taking a liver enzyme-inducing medicine for your epilepsy.

There is some evidence that the COC may interact with lamotrigine (Lamictal®) in some women. Lamotrigine is an anti-epilepsy medicine. It is not a liver enzyme inducer but may interact with the COC in another way. The interaction may work both ways. That is, the lamotrigine may make the pill less effective and the pill may also make the lamotrigine less effective and increase your risk of seizures. Therefore, the doses of both medications may need to be adjusted.

It may be preferable to consider an alternative method of contraception if you are taking lamotrigine and need to use contraception.

For reliable contraception, it is best to seek advice from a doctor or nurse. They will be able to tell you if your epilepsy treatment affects any methods of contraception.

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My 1st time I had a seizure in Dec 16 in the hospital, all the seizures stop a year later. so i have been free of seizures for more than a year, but two to three months i start have very small...

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