Лекарственные взаимодействия
Ethinyl estradiol + Lamotrigine
Тяжесть: Тяжёлое
Ethinyl estradiol and Lamotrigine: major interaction.
Последнее обновление Источники: US FDA label
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Кратко
Ethinylestradiol-containing contraceptives substantially reduce lamotrigine plasma concentrations, often by about half, which can lead to loss of seizure or mood control. During the pill-free or placebo week, lamotrigine levels rise again and may cause dose-related toxicity such as dizziness, diplopia, ataxia and nausea. Starting or stopping the contraceptive in a patient on lamotrigine requires dose attention.
Что означает это взаимодействие простыми словами
Ethinyl estradiol 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.
Почему это происходит
Estrogen induces UGT1A4-mediated glucuronidation of lamotrigine, increasing its clearance.
Что делать
When starting an estrogen-containing contraceptive in a stable patient, monitor clinical response and lamotrigine levels and increase the dose as needed, guided by response. When stopping it, expect levels to rise and reduce the dose accordingly.
О чём спросить фармацевта
- 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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Источники
Другие взаимодействия Lamotrigine
Частые вопросы
Can I take Ethinyl estradiol with Lamotrigine?
MediHelp rates the interaction as major. Ethinyl estradiol 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. Ethinylestradiol-containing contraceptives substantially reduce lamotrigine plasma concentrations, often by about half, which can lead to loss of seizure or mood control. During the pill-free or placebo week, lamotrigine levels rise again and may cause dose-related toxicity such as dizziness, diplopia, ataxia and nausea. Starting or stopping the contraceptive in a patient on lamotrigine requires dose attention.
How serious is the interaction between Ethinyl estradiol 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: When starting an estrogen-containing contraceptive in a stable patient, monitor clinical response and lamotrigine levels and increase the dose as needed, guided by response. When stopping it, expect levels to rise and reduce the dose accordingly.
What other medicines interact with Lamotrigine?
MediHelp also lists interactions of Lamotrigine with, for example, Desogestrel-ethinyl estradiol, Divalproex, Dofetilide. The full list is on the Lamotrigine page.
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