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Orlistat contraception counselling — GPhC CRA MCQ

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HardEndocrine TherapeuticsOrlistat contraception counsellingGPhC CRA

A patient taking Mercilon develops severe diarrhoea lasting more than 12 hours while using orlistat. Four active tablets remain in the current strip. What is the best contraceptive advice?

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Correct answer: B — Continue the tablets, use condoms for seven days and start the next strip without a break

Orlistat is not an enzyme inducer, but severe diarrhoea can reduce absorption of Mercilon. The product advice is to continue tablets and use additional non-hormonal contraception for seven days. Because only four active tablets remain, those seven days extend beyond the current strip, so the next strip must start immediately without the usual tablet-free interval. Doubling tablets after each loose stool or merely stopping orlistat does not restore reliable absorption.

Reference: Xenical 120 mg SmPC: https://www.medicines.org.uk/emc/product/2592/smpc; Mercilon SmPC: https://www.medicines.org.uk/emc/product/1360/smpc