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Date of last update: 9/5/2017.

Forum Name: Pharmacy & Drug Topics

Question: topamax and ortho evra

 kimberly - Mon Oct 13, 2003 8:47 pm

I am taking 75mg of topamax daily to treat migraines and it is working wonderfully. Since ortho evra does not break down in the liver, is the effectiveness of this type of birth control still decreased by the topamax? Also, while on the topic, with ortho evra, does antiobiotics decrease its effectiveness? I realize it is relatively new on the market, but does it really make a difference that it does not go through the liver to get into the rest of the body? thanks....
 Dr. Tamer Fouad - Sat Nov 15, 2003 6:59 am

User avatar Ortho Evra is a combination contraceptive pill that contains ethinyl estradiol and norgestril. Both components are liver enzyme substrates meaning that they are broken down in the liver. Topamax (toperamate) is an anticonvulsant which is a liver enzyme inducer meaning it stimulates liver enzymes to breakdown drugs that are substrates. It follows that there is a decrease in the blood level of ortho evra when used concomitantly with topamax.
Any antibiotic that affects the liver enzymes will affect ortho evra blood levels.

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