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Perampanel (more than 12 mgs daily)

If you take perampanel (more than 12 mgs daily)

Types of contraception that may work for you

Barrier methods

All barrier methods may work for you. These include:

  • Caps
  • Condoms
  • The coil
  • Diaphragms
  • Femidoms

Hormonal contraception

The hormonal contraception that may work for you include:

  • Combined oral contraceptive pill (the Pill) – but see box below
  • Depo-Provera contraceptive injection – but see box below
  • Mirena coil
  • Noristerat contraceptive injection

Unplanned (emergency) contraception

The unplanned (emergency) contraception that may work for you include:

  • The morning-after pill called Levonorgestrel (Levonelle) – but see box below. Other types of morning after pill are not recommended.
  • The coil

Combined oral contraceptive pill (the Pill)
Your doctor might suggest you follow these steps, to make it work better:

    • Take a version of the Pill that contains at least 50 micrograms of oestrogen and
    • Take the Pill all the time, without the usual seven day break each month and
    • Take a version of the Pill which has at least twice the amount of progestogen than usual

If you have bleeding during the time that you are taking the Pill, this could be a sign that the Pill is not working very well. In this case, your doctor may increase the dose of oestrogen in steps of 10 micrograms, up to a maximum of 70 micrograms. Even if you take a higher dose of the Pill, and even if you have no bleeding, it might still not work very well. For this reason, your doctor might advise you to use condoms as well, until they can be sure that the Pill would prevent you from getting pregnant. They can check if you are at risk of getting pregnant by giving you blood tests at certain times of the month. The blood tests show if the Pill has stopped you from ovulating (releasing an egg) This means that you shouldn’t get pregnant. Or, the doctor may advise you to change to a different type of contraception.

Depo-Provera contraception injection
These can speed up bone loss, as can some epilepsy medicines. This may lead to a condition called osteoporosis, which causes bones to become thinner and more brittle, so they break more easily. For this reason, the World Health Organisation (WHO) has suggested that Depo-Provera injections should be used with caution by some women. These are women who are under 18 and women who are over 45. However, WHO also say that the advantages of using Depo-Provera generally outweigh the disadvantages.

If you are considering using Depo-Provera injections, it’s advisable to seek advice about osteoporosis from your doctor.

More information about epilepsy and osteoporosis.

Levonorgestrel (Levonelle)
You should take a pill that contains 3 mg levonorgestrel, as soon as possible after sex. This is twice the amount of levonorgestrel that women who don’t take epilepsy medicines usually take. This dose must be prescribed by a doctor.

Guidelines suggest that the coil could be better than levonorgestrel at reducing the risk of pregnancy.

Types of contraception that are notrecommended for you

Hormonal treatment

The types of hormonal contraception that are not recommended are:

  • Contraceptive implant
  • Contraceptive patch
  • Progestogen-only pill (the mini pill)
  • Vaginal ring

Natural birth control

All types of natural birth control are not recommended.

Unplanned (emergency) contraception

The types of unplanned (emergency) contraception that are not recommended are:

  • The morning-after pill called Ulipristal acetate (EllaOne)

Information about different types of contraception.

Code: 
F058.04
Event Date: 
Friday 23 October 2015 - 12:42

Epilepsy Action would like to thank Beth Irwin, Epilepsy Nurse/Midwife at the UK Epilepsy and Pregnancy Register, Belfast, for her contribution to this information.

Beth Irwin has no conflict of interest to declare.

This information has been produced under the terms of The Information Standard.

  • Updated October 2015
    To be reviewed October 2018

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