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- W4200202223 abstract "Objectives: Topiramate, commonly used for the treatment of migraines and seizures, is categorized as an enzyme-inducing anti-epileptic drug (EIAED) like carbamazepine and phenobarbital. Limited data suggest topiramate is a mild inducer and may not affect contraceptive efficacy. We evaluated topiramate and etonogestrel (ENG) pharmacokinetic interactions in contraceptive implant users. Methods: We enrolled healthy women using ENG implants for 12-36 months. We measured baseline serum concentrations and then began a 6-week titrated topiramate regimen to standard migraine (3 weeks) and epilepsy (6 weeks) dosages. We repeated serum ENG concentrations at 3 weeks (100 mg/day), 4 weeks (200 mg/day), and 6 weeks (400 mg/day) of topiramate therapy. We measured ENG using a validated liquid chromatography-tandem mass-spectrometry assay and tested for changes in concentrations using Friedman's test for non-parametric, repeated, related-samples. Results: We enrolled 48 total participants; 32 completed 3-weeks, 31 completed 4-weeks, and 27 completed all follow-ups. Participants’ median age was 25.3 years (range 18.3-37.2), median BMI was 25.5 kg/m2 (range 18.7-42.2), and median duration of implant use was 24 months (range 12-36). Median ENG concentrations were 145pg/mL (range 79.9-816) at baseline, 128.5pg/mL (range 76.2-573) at three weeks, 121 pg/mL (range 71.8-575) at four weeks, and 109 pg/mL (range 54.3-853) at six weeks. Serum ENG concentrations significantly decreased with increasing topiramate dose (p<0.001). Only one participant at baseline (1/32) and one-third of participants (9/27) at six weeks had serum ENG concentrations <90 pg/mL. Conclusions: Though only a mild EIAED, a clinically significant portion of implant users reached ENG concentrations below the threshold for ovulatory suppression when taking anti-epileptic dosages of topiramate." @default.
- W4200202223 created "2021-12-31" @default.
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- W4200202223 date "2021-10-01" @default.
- W4200202223 modified "2023-09-28" @default.
- W4200202223 title "POSTER ABSTRACTS" @default.
- W4200202223 doi "https://doi.org/10.1016/j.contraception.2021.07.076" @default.
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