Lamictal and Zovia 1/35E (28)

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using lamoTRIgine together with ethinyl estradiol. Combining these medications may reduce the blood levels and effects of lamoTRIgine. You may need a dose adjustment if you have been taking lamoTRIgine and are starting treatment with ethinyl estradiol. Similarly, if ethinyl estradiol is discontinued, your dosage of lamoTRIgine may need to be readjusted. Contact your doctor if your condition changes or you experience loss of seizure control during treatment with these medications. When ethinyl estradiol is stopped or interrupted briefly, be alert to potentially increased side effects of lamoTRIgine such as dizziness, drowsiness, nausea, vomiting, diarrhea, blurred vision, incoordination, tremor, restlessness, irritability, depression, anxiety, and mood or behavior changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with estrogens or progestins may decrease the plasma concentrations and pharmacologic effects of lamotrigine due to induction of lamotrigine glucuronidation. One group of investigators cited seven suspected cases of this interaction in women treated with oral contraceptives that contained either ethinyl estradiol in combination with desogestrel or norethindrone or norethindrone alone. The contraceptives reduced plasma levels of lamotrigine by 41% to 64%, and a deterioration in seizure control was observed several days to two months after initiation of contraceptive use, necessitating an increase in lamotrigine dosage or discontinuation of the contraceptive. In some cases, contraceptive discontinuation led to lamotrigine toxicity that required dosage reduction. A pharmacokinetic study also reported similar reductions in lamotrigine plasma levels in patients on combination oral contraceptives, with lamotrigine clearance 2.5 times greater than in controls. The interaction is further supported by the fact that changes in hormone levels are known to influence the pharmacokinetics of glucuronidated drugs in humans, and elimination of lamotrigine is significantly increased during pregnancy. However, a population pharmacokinetics study in patients newly diagnosed with epilepsy and receiving oral lamotrigine monotherapy for up to 48 weeks found no significant effect of oral contraceptive use or dose on the oral clearance of lamotrigine. Lamotrigine also has been shown to have little or no effect on the pharmacokinetics of contraceptive hormones, although measurement of serum FSH, LH, and estradiol has indicated some loss of suppression of the hypothalamic-pituitary-ovarian axis. The clinical significance is unknown. Measurement of serum progesterone indicated no hormonal evidence of ovulation.

MANAGEMENT: Pharmacologic response and plasma lamotrigine levels should be monitored more closely whenever estrogen- and/or progestin-containing drugs are added to or withdrawn from therapy, and the lamotrigine dosage adjusted as necessary. The manufacturer's labeling should be consulted for detailed dosage recommendations. Patients should be advised to contact their physician if they experience loss of seizure control or symptoms of lamotrigine toxicity such as ataxia, nystagmus, increased seizures, irregular heartbeat, and changes in mental status. In patients receiving oral contraceptives, gradual transient increases in lamotrigine levels will occur during the pill-free week for women not also taking an enzyme-inducing drug (e.g., carbamazepine, phenytoin, phenobarbital, primidone, rifampin). The increase in lamotrigine levels will be greater if the dose of lamotrigine is increased in the few days before or during the pill-free week. Although diminished contraceptive efficacy has not been reported, the possibility should be considered. Patients should be instructed to promptly report changes in their menstrual pattern.

Lamictal

Generic Name: lamotrigine

Brand name: Lamictal, Lamictal ODT, Lamictal XR, Lamictal, Lamictal ODT, Lamictal XR, Subvenite, Lamictal CD, LaMICtal Starter Kit, LaMICtal ODT Patient Titration Kit, LaMICtal XR Patient Titration Kit, LamoTRIgine Starter Kit, Subvenite Starter Kit

Synonyms: n.a.

What is Lamictal?

Zovia 1/35E (28)

Generic Name: ethinyl estradiol / ethynodiol

Brand name: Kelnor, Zovia 1/35, Zovia 1/50, Demulen 1/35, Demulen 1/50, Zovia 1/35e, Kelnor 1/50, Kelnor 1/35, Zovia 1/50e

Synonyms: Zovia 1/35, Zovia 1/35E

What is Zovia 1/35E (28)?