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Drug interactions between Lamictal and Ortho Tri-Cyclen

Results for the following 2 drugs:
Lamictal (lamotrigine)
Ortho Tri-Cyclen (ethinyl estradiol/norgestimate)

Interactions between your drugs

Moderate

ethinyl estradiol lamoTRIgine

Applies to: Ortho Tri-Cyclen (ethinyl estradiol / norgestimate) and Lamictal (lamotrigine)

Talk to your doctor before using lamoTRIgine together with ethinyl estradiol. Combining these medications may reduce the blood levels and effects of lamoTRIgine. You may need a dose adjustment if you have been taking lamoTRIgine and are starting treatment with ethinyl estradiol. Similarly, if ethinyl estradiol is discontinued, your dosage of lamoTRIgine may need to be readjusted. Contact your doctor if your condition changes or you experience loss of seizure control during treatment with these medications. When ethinyl estradiol is stopped or interrupted briefly, be alert to potentially increased side effects of lamoTRIgine such as dizziness, drowsiness, nausea, vomiting, diarrhea, blurred vision, incoordination, tremor, restlessness, irritability, depression, anxiety, and mood or behavior changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

norgestimate lamoTRIgine

Applies to: Ortho Tri-Cyclen (ethinyl estradiol / norgestimate) and Lamictal (lamotrigine)

Talk to your doctor before using lamoTRIgine together with norgestimate. Combining these medications may reduce the blood levels and effects of lamoTRIgine. You may need a dose adjustment if you have been taking lamoTRIgine and are starting treatment with norgestimate. Similarly, if norgestimate is discontinued, your dosage of lamoTRIgine may need to be readjusted. Contact your doctor if your condition changes or you experience loss of seizure control during treatment with these medications. When norgestimate is stopped or interrupted briefly, be alert to potentially increased side effects of lamoTRIgine such as dizziness, drowsiness, nausea, vomiting, diarrhea, blurred vision, incoordination, tremor, restlessness, irritability, depression, anxiety, and mood or behavior changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

norgestimate food

Applies to: Ortho Tri-Cyclen (ethinyl estradiol / norgestimate)

Consumer information for this interaction is not currently available.

MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because grapefruit juice inhibits primarily intestinal rather than hepatic CYP450 3A4, the magnitude of interaction is greatest for those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability). In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4. Grapefruit and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

Moderate

lamoTRIgine food

Applies to: Lamictal (lamotrigine)

Alcohol can increase the nervous system side effects of lamoTRIgine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lamoTRIgine. Do not use more than the recommended dose of lamoTRIgine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Minor

ethinyl estradiol food

Applies to: Ortho Tri-Cyclen (ethinyl estradiol / norgestimate)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

Therapeutic duplication warnings

No therapeutic duplications were found for your selected drugs.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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