From the Guidelines
Oxcarbazepine (Trileptal) therapy is likely to reduce the effectiveness of combined hormonal contraceptives, progestin-only pills, and implants, making them less reliable for birth control.
Safe Birth Control Methods with Oxcarbazepine Therapy
- Intrauterine devices (IUDs): These are a good option as their effectiveness is not decreased by oxcarbazepine therapy 1.
- Depot medroxyprogesterone acetate (DMPA): This progestin-only contraceptive injection is also a safe choice, as its effectiveness is not reduced by oxcarbazepine 1.
- Copper IUDs: These are another option that is not affected by oxcarbazepine therapy.
- Barrier methods: Such as condoms, diaphragms, and cervical caps, can be used, but they have a higher failure rate compared to other methods.
Methods to Avoid or Use with Caution
- Combined hormonal contraceptives (CHCs): Including pills, patches, and rings, may have reduced effectiveness due to oxcarbazepine therapy 1.
- Progestin-only pills (POPs): May have decreased effectiveness with oxcarbazepine therapy, although the evidence is not as strong as for CHCs 1.
- Implants: Such as etonogestrel implants, may also have reduced effectiveness with oxcarbazepine therapy 1. It is essential to consult a healthcare provider to determine the best birth control method for individual circumstances, especially when taking oxcarbazepine therapy.
From the FDA Drug Label
Caution female patients of reproductive potential that the concurrent use of oxcarbazepine with hormonal contraceptives may render this method of contraception less effective [see Drug Interactions (7.2) and Use in Specific Populations (8. 1)]. Additional non-hormonal forms of contraception are recommended when using oxcarbazepine. Use of oxcarbazepine with hormonal contraceptives containing ethinylestradiol or levonorgestrel is associated with decreased plasma concentrations of these hormones and may result in a failure of the therapeutic effect of the oral contraceptive drug Advise women of reproductive potential taking oxcarbazepine who are using a contraceptive containing ethinylestradiol or levonorgestrel to use additional or alternative non-hormonal birth control [see Drug interactions (7.3) and Clinical Pharmacology (12.3)].
Safe birth control methods to use with Oxcarbazepine (Trileptal) therapy include:
- Non-hormonal forms of contraception, as hormonal contraceptives may be less effective due to decreased plasma concentrations of hormones such as ethinylestradiol or levonorgestrel 2 2. It is recommended that women of reproductive potential taking oxcarbazepine use additional or alternative non-hormonal birth control methods to ensure effective contraception 2.
From the Research
Birth Control Methods with Oxcarbazepine Therapy
- Oxcarbazepine (Trileptal) is known to decrease plasma levels of oral contraceptives, making alternative contraceptive methods necessary 3, 4
- Women taking oxcarbazepine should avoid oral contraceptives due to the enzyme-inducing properties of the medication 4
- If a woman is taking oxcarbazepine and wishes to take the oral contraceptive pill, she will need to take a preparation containing at least 50 microg of ethinylestradiol 5
- Levonorgestrel implants are contraindicated in women receiving oxcarbazepine due to cases of contraceptive failure 5
- Medroxyprogesterone injections can be used, but the dosage schedule may need to be adjusted to every 10 weeks instead of 12 weeks 5
Alternative Contraceptive Methods
- There is no specific information on the safety of other contraceptive methods, such as intrauterine devices (IUDs) or condoms, with oxcarbazepine therapy
- However, these methods may be considered as alternatives to oral contraceptives or other hormone-based contraceptives that may interact with oxcarbazepine 5, 3