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Re: Lamictal Questions

Posted by ed_uk2010 on February 1, 2012, at 8:19:57

In reply to Lamictal Questions, posted by papillon2 on February 1, 2012, at 0:37:13

>I'm looking for some help managing Lamictal (200mg) with the contraceptive pill (in this instance Yaz).

Ethinylestradiol, the estrogen present in most combined oral contraceptives, is the drug which interacts with lamotrigine (Lamictal).

Have you considered using a contraceptive which doesn't interact? The Mirena intra-uterine device is highly effective and convenient.

Nexplanon/Implanon, a small implant in the upper arm, is also very effective. If side effects occur the implant can be removed.

A slightly less reliable but simple alternative would be norethindrone/norethisterone (Ortho Micronor tablets etc.). These progestogen only pills are not believed to interact with Lamictal. I was going to suggest Cerazette, one of the most popular contraceptives in the world (!), but it seems not to be sold in the US for some reason. I'm guessing you're in the US. Cerazette is the latest progestogen-only pill and is easier to take than the others because it's still effective even if you don't take it at the exact same time each day. Ortho Micronor is effective but it does need to be taken precisely and not at any random time of day. Implanon and Mirena are more reliable. Mirena might be preferable for you because progesterone implants and injections occasionally cause psychiatric adverse reactions. Mirena also reduces heavy menstruation, if this is a problem.

>My psychiatrist says there isn't but people with epilepsy get their level taken so it must be possible.

It is possible. Blood levels are sometimes used to adjust the dose during pregnancy, but the value of measuring blood levels isn't as clear with lamotrigine as with some of the other antiepiletics (especially phenytoin/Dilantin).

 

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poster:ed_uk2010 thread:1008965
URL: http://www.dr-bob.org/babble/20120120/msgs/1008988.html