Does Topiramate Decrease the Efficacy of Oral Contraceptives?

SYNOPSIS: In this retrospective cohort study, women taking low-dose topiramate (< 200 mg per day) and oral contraception did not have more contraceptive failures compared to women taking other headache remedies (propanolol, metoprolol, amitriptyline, venlafaxine, or verapamil), with an adjusted rate difference of 0.00 (95% confidence interval, -0.3, 0.3).

SOURCE: Sarayani A, Winterstein A, Cristofoletti R, et al. Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes. Contraception 2023;120:109953.