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The general rule of thumb is that the hormonal stuff will lower your lamotrigine levels somewhat, and you will have to take more lamotrigine than you would otherwise. It's fairly common, though, so your doctor should know about and be prepared for anything like that already.

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The estrogens in oral contraceptives will lower lamotrigine levels by up to 50%. If you stop the OCs, then you need to reduce the lamotrigine.

If your doc uses a *progestin-only pill,* the issue is moot. But you can't miss a single dose, and they ain't foolin' about the same time, and you need to talk to your prescriber about the relative efficacy of a progestin-only contraceptive and why that might or might not be the right choice for you.

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