Drug Interactions with Hormonal Contraception FSRH CEU Jan 2018

Question 1

Use of contraceptive methods when woman is using an enzyme-inducer (and within 28 days of stopping treatment)

Answer 1

Antiepileptics - carbamazepine, - eslicarbazepine, - oxcarbazepine, - phenobarbital, - phenytoin, - primidone, - rufinamide topiramate

Antibiotics - rifabutin, - rifampicin

Antiretrovirals - Always use the HIV Drug Interaction Checker (www.hiv-druginteractions.org)

Antidepressants - St John’s wort

Others - modafinil, (mou DAF-ə-nəl) (wakefulness) - bosentan, (bo SEN tən) (pulmonary arterial HTN) -

aprepitant (ə-ˈpre-pə-tənt) (nausea and vomiting by chemotherapy & after surgery.

Question 2

Use of contraceptive methods when woman is using an enzyme-inducer (and within 28 days of stopping treatment) general advice

Answer 2

When starting then advised of potential interaction with hormonal contraception and be offered a reliable method unaffected. - require EC should be advised of potential interactions with oral methods and offered a Cu-IUD. If a Cu-IUD is unacceptable or unsuitable, a double dose of LNG-EC may be used. - Short-term use of enzyme-inducing drugs (<2 months) can be managed more flexibly than longer-term use. Continuing method with consistent and careful use of condoms may be appropriate

Question 3

Quick reference for non-enzyme-inducing drugs and contraception

Answer 3