Does Nexstellis (esomeprazole and estradiol) affect lamotrigine?

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Last updated: May 12, 2025View editorial policy

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From the Guidelines

Nexstellis can potentially decrease the effectiveness of lamotrigine by increasing its clearance from the body, and patients taking both medications may require a higher lamotrigine dose to maintain therapeutic effects. When taken together, Nexstellis may increase the clearance of lamotrigine from the body, potentially reducing lamotrigine blood levels by approximately 20-40% 1. This interaction occurs because the estrogen component in Nexstellis induces the glucuronidation of lamotrigine, accelerating its metabolism and elimination. Some key points to consider include:

  • The interaction between Nexstellis and lamotrigine is similar to that seen with other combined hormonal contraceptives containing estrogen 1.
  • Patients taking both medications may require a higher lamotrigine dose to maintain therapeutic effects, particularly for seizure control or mood stabilization.
  • If you're currently taking lamotrigine and plan to start or stop Nexstellis, consult your healthcare provider about potential dose adjustments.
  • They may recommend monitoring lamotrigine blood levels and watching for breakthrough seizures or mood symptoms.
  • During the hormone-free week of Nexstellis, lamotrigine levels may temporarily increase, potentially causing side effects.

From the Research

Nexstellis and Lamotrigine Interaction

  • There are no research papers to assist in answering this question as none of the provided studies mention Nexstellis.
  • The studies provided focus on lamotrigine interactions with other drugs such as valproic acid, carbamazepine, and phenytoin 2, 3, 4.
  • Lamotrigine has been shown to have pharmacokinetic and pharmacodynamic interactions with various drugs, which can affect its efficacy and safety 2, 3, 5.
  • However, without specific information on Nexstellis, it is not possible to determine its potential interaction with lamotrigine.
  • Drug-drug interactions can have significant consequences, including adverse drug events and increased healthcare costs 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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