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Perampanel and oral contraceptives

A new review has highlighted the possibility that higher dosages of the once-a-day anti-epileptic medication, perampanel, may affect the reliability of the oral contraceptive pill. When the medication is taken at doses of more than 8mg, it can speed up the metabolism of progesterone in the pill, and this may make it less effective.

The patient information leaflet for perampanel (Fycompa) stresses that anyone prescribed this medication - regardless of dose - should let their GP or pharmacist know if they are taking hormonal contraceptives.

Epilepsy Society consultant neurologist Dr Fergus Rugg-Gunn said: 'It is recommended that women who have been prescribed perampanel should also use an additional, reliable, non-hormonal method of contraception.'

Author of the review, Professor Philip Patsalos who is head of the Therapeutic Drug Monitoring Unit at Epilepsy Society, explained: ' Two open-label studies have been undertaken involving a group of 48 healthy pre-menopausal women aged between 19 and 43 years. The volunteers were taking both perampanel and an oral contraceptive over 21 days. The mean blood concentrations of the levonorgestrel component of the pill were decreased by 40 per cent in those volunteers who took  doses of 12mg.’

The review, ‘The clinical pharmacology profile of the new antiepileptic drug perampanel: A novel non-competitive AMPA receptor antagonist’, published in Epilepsia, also highlighted that the absorption of perampanel is unaffected by food and can be taken at any time, regardless of  mealtimes.