If you’re being treated for epilepsy, then it’s important to think about what this might mean for your birth control methods.
Some anti seizure medication can interact with birth control. If you take them at the same time, it could increase your chances of having an unplanned pregnancy.
Also, certain birth control methods can make your seizure medication less effective. That could increase your chances of having seizures.
In this article, you’ll find more information about epilepsy and birth control.
Who needs to think about epilepsy treatment and birth control?
If you are sexually active or are planning to have sex, it’s always a good idea to think about birth control.
Depending on your situation, you may have more to think about.
1. Possible interaction: Some seizure medicines can interact with some birth control methods and make one or the other less effective. Keep reading below for more information.
2. No interaction: Other birth control methods will not interact with your seizure medication. If you use these birth control methods, you can use any epilepsy medication that works for you. These include:
- All kinds of intrauterine devices (IUD) - including copper and hormonal IUDs.
- Contraceptive injections like depo-medroxyprogesterone (depo). This is an injection doctors usually give every 12 weeks. It’s recommended that women who take epilepsy medication have it every 10 weeks.
- Condoms and diaphragms. But beware that these are not 100% effective at preventing pregnancy.
- Some non enzyme-inducing epilepsy medicines (see below for a list).
Related: What is catamenial epilepsy?
Epilepsy medication - interactions with hormonal birth control
Hormonal birth control is very effective at preventing unplanned pregnancies, and is often the first choice for many women. But if you take anti seizure medications, they could make your birth control less effective.
Hormonal birth control methods include:
- Combined oral contraceptive pill (‘the Pill’)
- Progesterone-only pill (‘mini pill’)
- Emergency contraceptive pill (the ‘morning after pill’)
- Contraceptive implants
- Hormonal skin patches
- The vaginal ring
Which anti-seizure medications make hormonal birth control less effective?
Some anti-seizure medicines are known as ‘enzyme-inducing drugs’. They produce enzymes (proteins that accelerate chemical reactions) in your body that rapidly break down certain hormones, including the hormones in your birth control. That makes hormonal birth control methods less effective.
Many common epilepsy medicines are enzyme-inducing. These include:
- Carbamazepine (Tegretol)
- Cenobamate (Xcorpi)
- Clobazam (Onfi or Sympazan)
- Eslicarbazepine (Aptiom)
- Felbamate (Felbatol)
- Lamotrigine (Lamictal)
- Oxcarbazepine (Trileptal)
- Perampanel (Fycompa)
- Phenobarbital (Luminal)
- Phenytoin (Dilantin)
- Perampanel (Fycompa)
- Primidone (Mysoline)
- Rufinamide (Inovelon)
- Topiramate (Topamax)
Always read the packaging or ask your doctor/pharmacist if you are unsure. The Epilepsy Pregnancy website has more information on this topic.
Some anti-seizure medicines don’t interact with birth control
Other anti-seizure medications are not enzyme-inducing. This means they shouldn’t affect hormonal birth control methods. These include:
- Acetazolamide
- Brivaracetam
- Clonazepam
- Ethosuximide
- Everolimus
- Gabapentin
- Lacosamide
- Lamotrigine
- Levetiracetam
- Piracetam
- Pregabalin
- Sodium valproate
- Stirapentol
- Tiagabine
- Valproic acid
- Vigabatrin
- Zonisamide
Lamictal and birth control - making anti-seizure medicine less effective
Hormonal birth control such as the Pill can make some anti-seizure medicines less effective too. This increases your chances of having a seizure.
There is clear evidence that hormonal birth control makes lamotrigine (Lamictal) less effective. If you take lamotrigine and want to use hormonal birth control, then speak with your doctor. It may be possible to increase your dosage of lamotrigine to compensate, but this will require regular blood tests to reduce your risk of having a breakthrough seizure.
There is also some evidence to suggest that hormonal birth control makes other kinds of anti-seizure medication less effective (although it might depend on the individual woman). This includes valproate, oxcarbazepine, eslicarbazepine and retigabine.
Avoiding an unplanned pregnancy while taking seizure medication
If you are taking anti-seizure medication for epilepsy and wish to avoid getting pregnant, it’s always worth speaking with your gynecologist or family doctor. There are a few different options they might suggest:
1. They may recommend choosing a birth control method that won’t interact with your anti-seizure medications. An IUD or depo, for example, are extremely effective at preventing unplanned pregnancies, and won’t interact with your seizure medication.
2. If you prefer to use hormonal birth control, such as the Pill, then your doctor may suggest ‘doubling up’ on birth control measures. You could continue taking the Pill and also:
- Tell your partner to wear a condom.
- Wear a diaphragm (‘female condom’).
- Use a spermicide.
- Tell your partner to withdraw before he ejaculates.
3. Finally, if you and your partner have decided you don’t want to have children, you could have a tubal ligation (when your fallopian tubes are tied up) or a vasectomy (for men).
Keep reading: 5 thing to know about women with epilepsy
Speaking with your doctor
Because every woman is different and your epilepsy experience and treatment is unique to you, it’s really valuable to speak to a doctor about birth control and your options. They can check possible interactions with seizure medications, and help you decide on what’s best for you.
It can sometimes feel ‘awkward’ talking about sex with medical professionals, pharmacists or family doctors. But remember, they see these kinds of issues every day. By getting personalized advice, you can enjoy sex on your own terms, without having to worry about unplanned pregnancies.
FAQs about birth control and common epilepsy medication
What birth control can I take with lamotrigine?
Hormonal birth control such as the Pill is known to make lamotrigine (Lamictal) less effective. While it’s always best to check with a pharmacist or your doctor, the most effective method would usually be to use an IUD, depo injections, or a condom/diaphragm.
Can I take Topiramate and birth control pills?
Topiramate is known to make hormonal birth control, such as the Pill, less effective. It’s worth speaking with your doctor about alternative methods of birth control, such as IUD, depo injections, or a condom/diaphragm.
Can I take Phenytoin and birth control pills?
Phenytoin is known to make hormonal birth control, such as the Pill, less effective. It’s worth speaking with your doctor about alternative methods of birth control, such as IUD, depo injections, or a condom/diaphragm.
Can I take carbamazepine and birth control pills?
Carbamazepine is known to make hormonal birth control, such as the Pill, less effective. It’s worth speaking with your doctor about alternative methods of birth control, such as IUD, depo injections, or a condom/diaphragm.
Can I take oxcarbazepine and birth control pills?
Oxcarbazepine is known to make hormonal birth control, such as the Pill, less effective. It’s worth speaking with your doctor about alternative methods of birth control, such as IUD, depo injections, or a condom/diaphragm.
Can I take levetiracetam (Keppra) and birth control pills?
Yes, you may be able to take Keppra with hormonal birth control methods, because Keppra is less likely to interact with birth control pills. You should always talk with your doctor first before taking any new medication.
Can birth control cause seizures?
Although hormonal birth control doesn’t directly cause seizures, there is evidence that they can make some anti-seizure medicine less effective. That could mean you are more likely to have a seizure. Always speak to your doctor or pharmacist about medicines you take, so they can check for possible interactions.
