Drug interactions
Levonorgestrel + Topiramate
Severity: Moderate
Levonorgestrel and Topiramate: moderate 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
Topiramate, particularly at higher doses, may reduce hormonal contraceptive exposure and increase the risk of contraceptive failure. Data with emergency or progestin-only levonorgestrel are limited, but a reduced effect is plausible.
What this interaction means in plain words
Levonorgestrel and Topiramate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levonorgestrel belongs to Endocrine; Topiramate belongs to Central Nervous System.
Why it happens
Dose-dependent CYP3A4 induction by topiramate increases levonorgestrel metabolism.
What to do
Advise an additional barrier method or a non-hormonal alternative while on topiramate, especially at doses above 200 mg daily. For emergency contraception, consider a copper IUD or discuss a higher dose with a specialist.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Topiramate
Other interactions of Levonorgestrel
Frequently asked questions
Can I take Levonorgestrel with Topiramate?
MediHelp rates the interaction as moderate. Levonorgestrel and Topiramate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Topiramate, particularly at higher doses, may reduce hormonal contraceptive exposure and increase the risk of contraceptive failure. Data with emergency or progestin-only levonorgestrel are limited, but a reduced effect is plausible.
How serious is the interaction between Levonorgestrel and Topiramate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise an additional barrier method or a non-hormonal alternative while on topiramate, especially at doses above 200 mg daily. For emergency contraception, consider a copper IUD or discuss a higher dose with a specialist.
What other medicines interact with Topiramate?
MediHelp also lists interactions of Topiramate with, for example, Benzhydrocodone / acetaminophen, Buprenorphine long-acting, Buprenorphine subdermal implant. The full list is on the Topiramate page.
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