Potential lamotrigine and COC interaction questioned
Hormonal contraception can be taken with lamotrigine, researchers
argue |
A possible interaction between lamotrigine and the combined oral contraceptive
pill has been called into question by the Faculty of Family Planning
and Reproductive Health Care clinical effectiveness unit (PDF 190K).
The unit reviewed available literature and found no evidence that lamotrigine
reduces the effectiveness of hormonal contraceptives. It concludes that
there is no good evidence to suggest that non-hormonal methods should
be used in favour of the combined oral contraceptive pill in women taking
lamotrigine.
Despite advice issued by GlaxoSmithKline earlier this year that women
taking lamotrigine should consider
non-hormonal methods of contraception (PJ, 16 July, p74), the unit recommends
that women may choose to use a hormonal method of contraception, after
counselling about the current clinical evidence.
A spokesman for GSK said that the company stands by its most recent prescribing
information. “In a recent pharmacology study no subjects showed
hormonal evidence of ovulation when lamotrigine was used together with
combined oral contraceptive but changes observed in serum levels of reproductive
hormones may indicate the potential for some loss of suppression of ovarian
activity in some women.
“Women starting Lamictal should have a review of their contraception
and the use of effective non-hormonal methods should be considered.”
The unit did find evidence to support GSK’s warning that starting
an oral contraceptive may reduce seizure control in women on a stable
dose of lamotrigine, and that the maintenance dose of lamotrigine may
need to be doubled in these women. |
The
Pharmaceutical Journal
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