MAJOR — Use With Caution
FDA-documented interaction. Contraceptive failure has been reported. Use additional or alternative contraception.
Evidence level: STRONG
Carbamazepine (Tegretol) can make birth control pills less effective by speeding up the breakdown of hormones. This can lead to unintended pregnancy.
Carbamazepine induces CYP3A4, increasing metabolism of ethinyl estradiol and progestins. Can reduce contraceptive efficacy. FDA labels for both drugs warn about this.
Use backup contraception (condoms) or discuss alternative contraceptive methods with your doctor. Long-acting methods like IUDs (especially copper IUD) are more reliable with enzyme-inducing drugs.
Take Carbamazepine at exactly the same times each day — consistency is critical for seizure control. Combined Oral Contraceptives follows its prescribed schedule. Antiepileptics are potent enzyme inducers that can change how your body processes many other medications.
Sole reliance on hormonal contraception
Breakthrough bleeding or spotting, which may indicate reduced hormone levels and reduced protection
Discuss IUD (copper or high-dose levonorgestrel), depot medroxyprogesterone, or barrier methods. Standard-dose pills may not provide adequate protection.
Antiepileptic drug levels are sensitive to enzyme inducers and inhibitors. Discuss any changes with your neurologist before adding new substances. Safer supplement options: magnesium, omega-3s, and B vitamins are generally well-tolerated alongside seizure medications.
Carbamazepine (Tegretol) can make birth control pills less effective by speeding up the breakdown of hormones. This can lead to unintended pregnancy.
Take Carbamazepine at exactly the same times each day — consistency is critical for seizure control. Combined Oral Contraceptives follows its prescribed schedule. Antiepileptics are potent enzyme inducers that can change how your body processes many other medications.
Breakthrough bleeding or spotting, which may indicate reduced hormone levels and reduced protection
Antiepileptic drug levels are sensitive to enzyme inducers and inhibitors. Discuss any changes with your neurologist before adding new substances. Safer supplement options: magnesium, omega-3s, and B vitamins are generally well-tolerated alongside seizure medications.
Discuss IUD (copper or high-dose levonorgestrel), depot medroxyprogesterone, or barrier methods. Standard-dose pills may not provide adequate protection.
Or browse the full interaction database (121,000+ pairs).