Drug interactions
Ethinyl estradiol-drospirenone + Lamotrigine
Severity: Major
Ethinyl estradiol-drospirenone and Lamotrigine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ethinyl estradiol-containing contraceptives substantially lower lamotrigine concentrations, which may lead to loss of seizure or mood control. Lamotrigine levels rise during the pill-free week, which may cause toxicity such as dizziness, diplopia and ataxia.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Lamotrigine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ethinyl estradiol-drospirenone belongs to Endocrine; Lamotrigine belongs to Central Nervous System.
Why it happens
Ethinyl estradiol induces UGT-mediated glucuronidation of lamotrigine, increasing its clearance.
What to do
Monitor clinical response and lamotrigine levels when starting or stopping the contraceptive, and adjust the lamotrigine dose as needed. Consider continuous active-pill use to limit fluctuations during the pill-free week.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
Other interactions of Lamotrigine
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Lamotrigine?
MediHelp rates the interaction as major. Ethinyl estradiol-drospirenone and Lamotrigine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ethinyl estradiol-containing contraceptives substantially lower lamotrigine concentrations, which may lead to loss of seizure or mood control. Lamotrigine levels rise during the pill-free week, which may cause toxicity such as dizziness, diplopia and ataxia.
How serious is the interaction between Ethinyl estradiol-drospirenone and Lamotrigine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and lamotrigine levels when starting or stopping the contraceptive, and adjust the lamotrigine dose as needed. Consider continuous active-pill use to limit fluctuations during the pill-free week.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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