advancedcarbamazepineCYP3A4 inductionoral contraceptivesdrug interactioncontraceptive failure
A 40-year-old female with bipolar I disorder stabilized on carbamazepine 800 mg daily is found to be taking oral contraceptive pills (ethinyl estradiol/norgestrel). She reports no recent breakthrough mood episodes, but her psychiatrist is concerned about a critical drug interaction. Which of the following best describes the pharmacokinetic concern?