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What is Sheela 26-year-old female, currently taking phenytoin for idiopathic grand mal epilepsy, and is consulting you because she wants to avoid pregnancy. She is on oral contraceptive pills (OCPs) for the time being. She has searched the internet and read that phenytoin could decrease the effectiveness of her OCPs. Which one of the followings is a suitable alternative? and explain in detail?
Lamotrigine * Lamotrigine (Lamictal) is an excellent alternative in those who wish to avoid pregnancy while taking OCPs. * Topamirate (Topamax) decreases the effectiveness of OCPs; the rest are enzyme inducers that increase the catabolism of OCPs.