Hesperian Health Guides
Birth control and antiseizure medicine
HealthWiki > Epilepsy and Seizures > Chapter 7: Pregnancy and birth with epilepsy > Birth control and antiseizure medicine
Family planning methods prevent pregnancy in different ways. Some contain hormones similar to those produced by your body. Hormonal methods include pills, injections, implants, patches, vaginal rings, and some IUDs (intrauterine devices).
Many antiseizure medicines interact with hormonal birth control methods and make them less effective or not effective. This is true for methods that contain both estrogen and progesterone as well as for methods containing progesterone only.
Antiseizure medicines that do not affect hormonal birth control: clonazepam *, ethosuximide, levetiracetam, valproic acid
Antiseizure medicines that make hormonal birth control less effective: carbamazepine, clobazam, oxcarbazepine*, phenobarbital, phenytoin, primidone*, eslicarbazepine acetate*, topiramate*, felbamate*
(Medicines names with * are not included in Chapter 4: Medicines for epilepsy and seizures, because they are not available in many communities Where they are available, this information is useful to know.)
If you use an antiseizure medicine that makes hormonal birth control less effective but do not want to get pregnant now, talk to a health worker about nonhormonal family planning methods, such as condoms, diaphragms, non-hormonal IUDs, cervical caps, and other methods that can always be used effectively by people with epilepsy who are taking any antiseizure medicine.
The opposite can happen tooâhormonal methods of birth control can make some antiseizure medicines less effective.
Lamotrigine and valproic acid can be less effective at controlling seizures when used with hormonal birth control methods. If this happens to you, talk to a health worker about finding a different birth control method or about adjusting the dose or changing your antiseizure medicine.
Valproic acid, phenobarbital, and carbamazepine can reduce a personâs desire to have sex. This may make getting pregnant more difficult.
Starting birth control after giving birth. Because you can get pregnant again soon after giving birth, talk to a midwife or other health worker about starting or restarting birth control. For more information, scan the QR code below to access Hesperianâs Family Planning mobile application.
Emergency contraception (EC) when taking antiseizure medicine. Emergency contraception (EC) is a way to avoid pregnancy after unprotected penis-in-vagina sex, but it is only effective if used soon after having sex.
A person taking antiseizure medicines can use EC pills safely. However, some medicines for HIV or tuberculosis (TB) lessen the effectiveness of EC pills. If this is a concern, talk to a health worker about using a higher EC dose or a copper IUD to prevent pregnancy.
For the health worker. People are often shy or embarrassed to talk about birth control because a conversation about birth control is also a conversation about sex. The stigma faced by people with epilepsyâespecially womenâregarding sex, relationships, and pregnancy can make it even harder for them to learn about and get the birth control they need.
By discussing family planning and its benefits with the people you treat, including those with epilepsy, you can be sure they will get correct information they can use to increase their control over their life and health.
Remember that people with epilepsy may have other health conditions (high blood pressure, HIV, TB, etc.) that can affect their options for safe, effective family planning options. Also, try to be sensitive to the social and family pressures that may affect their choices around family planning. This will help you offer care, information, and options that better fit each personâs needs.
For more information about family planning, scan the QR code to access Hesperianâs Family Planning mobile application.
