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Rifampicin-hormonal contraception interaction — GPhC CRA MCQ

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ModerateDrug InteractionsRifampicin-hormonal contraception interactionGPhC CRA

A 28-year-old woman on the combined oral contraceptive pill presents with a prescription for rifampicin 600 mg once daily for three months for latent tuberculosis. What is the most important advice regarding her contraception?

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Correct answer: E — She should use additional barrier contraception while taking rifampicin and for 28 days after stopping, and consider switching to a non-hormonal method or an IUD

Rifampicin is one of the most potent enzyme inducers and significantly reduces the effectiveness of hormonal contraception, including combined and progesterone-only pills, patches, and rings. The FSRH recommends using a reliable non-hormonal method such as a copper IUD, or ensuring additional barrier methods are used during treatment and for at least 28 days after stopping rifampicin. Doubling the pill dose is not sufficient to overcome the interaction.

Reference: BNF; FSRH Guideline Drug Interactions with Hormonal Contraception