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Steroid-induced dyspepsia risk — GPhC CRA MCQ

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HardEndocrine TherapeuticsSteroid-induced dyspepsia riskGPhC CRA

A woman taking modafinil for narcolepsy relies on a combined oral contraceptive and plans pregnancy later this year. Which counselling plan is correct?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Arrange an effective alternative or additional method during modafinil and for two months after stopping

Option B is correct: modafinil induces CYP3A4/5, may reduce steroidal-contraceptive effectiveness, and requires effective alternative or additional contraception during treatment and for two months after stopping. Option E reverses the mechanism. Option C ignores persistent induction and daily pregnancy risk. Option A stops precautions too early. Option D is not a validated solution to enzyme induction and increases hormone exposure.

Reference: MHRA modafinil safety update: https://www.gov.uk/drug-safety-update/modafinil-provigil-increased-risk-of-congenital-malformations-if-used-during-pregnancy