A patient is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:

1. Contraceptive failure
2. Excessive weight gain
3. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
4. Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed