If a patient has seizures that are well controlled on carbamazepine (Tegretol). No other issues. Doesn’t want to get pregnant for the next several years. What is the best option for her? Answer: Mirena IUD.
An effective option for women taking antiepileptic medications would be an intrauterine device. The levonorgestrel (progestin only) IUD and copper IUD are acceptable choices even for a nulligravida. The single-rod implantable progestin system also would be an acceptable choice for this patient.
Certain antiepileptic drugs induce hepatic metabolism of estrogen and progestin (carbamazepine, oxcarbazepine, phenobarbital, phenytoin, and topiramate). This can potentially lead to failure of any contraceptive that contains estrogen and progestin.