Epilepsy and Contraception

Question 1

What form of contraception does the FSRH recommend in addition to other forms of contraception in women with epilepsy?

Answer 1

Condoms

Question 2

Which drugs are UKMEC3 for COCP and POP and UKMEC2 for the implant?

Answer 2

• Phenytoin
• Carbamazepine
• Barbiturates
• Primidone
• Topiramate
• Oxcarbazepine

Question 3

What are the UKMECs associated with contraceptives in patients taking Lamotrigine?

Answer 3

COCP = UKMEC 3
POP = UKMEC 1
Implant = UKMEC 1

Question 4

Which contraceptive options are UKMEC 1 in patients taking EIDs?

Answer 4

IUD
IUS
Depo-provera

Question 5

What should you advise in patients taking EID who want to take the COCP?

Answer 5

• Inform them that effectiveness decreases
• The COCP should contain minimum 30mcg ethinyloestradiol
• Recommend the dose is increased to 50mcg with no pill-free interval, or reduced from 7 to 4 days
• Barrier methods also advised (both when on the EID and an additional 4 weeks after stopping)