Contraception for people taking Lamotrigine

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Lamotrigine is a medication which is taken for seizure control, prescribed by the GP or a specialist neurologist, or as a mood stabiliser, prescribed by a psychiatrist.

Some contraceptives and lamotrigine can affect each other. Guidance has been released relating to hormonal contraception and lamotrigine, which may affect your contraceptive choice.

This information sheet is available to help you make the right decision for you about your contraception.

These are contraceptives which contain the hormones oestrogen and progesterone.

Combined hormonal contraception includes certain pills, the contraceptive patch and the vaginal ring. These are not recommended with lamotrigine as they may change the levels of lamotrigine in your blood, increasing the risk of seizures or mood changes.

Occasionally you may be given combined hormonal contraception if other contraceptive methods have not suited you. If this is the case it will normally be done together with your GP and specialist with blood tests to check your lamotrigine levels. If you are unsure if your contraceptive falls into this category, please check with your contraception provider.

These are contraceptives which contain the single hormone progesterone, such as the progesterone only pill (POP, e.g. desogestrel), the contraceptive injection (DepoProvera® or Sayana Press®) and contraceptive implant (Nexplanon®). These may interact with lamotrigine in different ways.

The effectiveness of copper and hormone intrauterine contraception (also known as coils or IUS or IUD) and the injection (DepoProvera® or Sayana Press®) are not changed by lamotrigine and are recommended first-line contraception for people on lamotrigine.

There may be an increase in the chance of pregnancy when also taking lamotrigine however, the evidence for this is limited and the risk is likely to be small. If you wish to use these contraceptives, the national advice is to also always use condoms along with them.

If you accept the small risk of the POP or implant not working as well as it could if you were not taking lamotrigine and choose not to use condoms, we will support you with your contraceptive choice.

Lamotrigine levels may increase when taken with POP, implant or injection. The signs of too much lamotrigine are dizziness, double vision, problems with balance and/or co-ordination. However, this is very rare. You should contact your doctor if you experience any of these when taking hormonal contraception.

The efficacy of condoms is not affected by lamotrigine.

Stopping the POP/implant/injection may lower the levels of lamotrigine in your body. This could put you at higher risk of seizure or mood changes. This is also very rare.

It is a good idea to speak to your specialist or GP about this before to stopping contraception to plan your pregnancy.

We advise taking folic acid for at least three months before you try for a baby and also vitamin D during pregnancy and any breastfeeding.

PET is available to help with any of your compliments, concerns or complaints, and will

ensure a prompt and efficient service:

Nottingham University Hospitals: 0800 183 02 04

Email: nuhnt.PALS@nhs.net

King’s Mill Hospital: 01623 672222

Newark Hospital: 01636 685692

Email: sfh-tr.PET@nhs.net

If you would like this information in an alternative format, for example large print or easy

read, or if you need help with communicating with us, for example because you use British Sign Language, please let us know. You can contact the Patient Experience Teams using the details above.