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Antibiotics and hormonal contraception — GPhC CRA MCQ

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ModerateDrug InteractionsAntibiotics and hormonal contraceptionGPhC CRA

A 45-year-old woman presents with a new prescription for co-amoxiclav 625 mg three times daily for seven days for a skin infection. She is currently taking the combined oral contraceptive pill. She asks if the antibiotic will affect her contraception. What is the most appropriate advice?

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Correct answer: B — Co-amoxiclav does not affect the effectiveness of hormonal contraception, and no additional precautions are needed unless she has vomiting or severe diarrhoea

Non-enzyme-inducing antibiotics, including co-amoxiclav, do not reduce the effectiveness of hormonal contraception. Additional contraceptive precautions are only needed if the antibiotic causes vomiting or severe diarrhoea that may impair absorption. Enzyme-inducing antibiotics such as rifampicin and rifabutin are the exceptions that do significantly reduce contraceptive efficacy. The FSRH provides clear guidance on this.

Reference: BNF; FSRH Guideline Drug Interactions with Hormonal Contraception