Antiepileptic Drugs and Contraception

Certain antiepileptic drugs (AEDs) can interact with hormonal contraceptives and decrease their effectiveness, leading to unplanned pregnancy. In addition, hormonal contraception can have a bidirectional interaction with some AEDs, which can result in loss of seizure control or toxicity. Several contraceptive options that do not interact with AEDs, such as barrier and longacting forms, are available. High dosages of emergency contraception and oral regimens also may be considered. Intervention by the pharmacist can include making recommendations about contraceptive options, advising on therapeutic drug concentration monitoring, and increasing awareness among patients and prescribers.