Epilepsy and oral hormonal contraception-Indian perspective

Hebbar, Shripad (2017) Epilepsy and oral hormonal contraception-Indian perspective. International Journal of Pharmacy and Pharmaceutical Sciences, 9 (3). pp. 1-6. ISSN 0975-1491

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There are about 50 million people with epilepsy in the world and a quarter of them are in the reproductive age group. India alone contributes to 10% of this fig. Because of the advances in therapeutic drugs, the women affected with epilepsy easily enter into reproductive life. These women like others are highly fertile and frequently need to adopt effective and safe contraceptive measures to avoid unplanned pregnancy. There are several concerns regarding the efficacy and safety of natural methods or barrier methods in women who are taking antiepileptic drugs (AED), failure of which poses a great risk to the affected person because pregnancy can result in exposure of fetus to the teratogenic effect of AEDs and also the hemodynamic changes in pregnancy can lower the plasma concentrations of AED and there can be poor seizure control. Oral hormonal pills are prescribed to epileptic women, not only for birth control but also in certain situations such as polycystic ovaries, irregular menstruation, acne and dysfun tional uterine bleeding. There are major bidirectional interactions between reproductive hormones and antiepileptic drugs which the physician should be aware of while dealing with these women. There are now enough evidence that oral contraceptive pills can reduce the efficacy of AEDs by affecting their metabolism and also AEDs by themselves may affect the contraceptive efficacy of oral pills by different pathways. Though estrogen free hormonal contraception is least likely to be effected by this nature of drug interaction, but still caution should be exercised in drug prescription as progesterone by itself has a lesser contraceptive effect and hence even slighted drug interaction too can lead to contraceptive failure. This extensive review focusses upon potential drug interactions between constituents of various oral pills and anti-epileptic drugs, the formulations available in India with different dosages for oestrogen and newer progestogens with their advantages with a special note on ormeloxifene which is exclusively marketed for birth control in Rural India. Special conditions such as contraception during lactation and emergency contraception for epileptic women are also discussed.

Item Type: Article
Uncontrolled Keywords: Oral contraception; Epilepsy; Anti-Epileptic Drugs (AED); Hepatic enzyme induction; Ormeloxifene.
Subjects: Medicine > KMC Manipal > Obstetrics & Gynaecology
Depositing User: KMC Library
Date Deposited: 13 Mar 2017 04:44
Last Modified: 13 Mar 2017 04:44
URI: http://eprints.manipal.edu/id/eprint/148421

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