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Rifampicin and contraception — GPhC CRA MCQ

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HardDrug InteractionsRifampicin and contraceptionGPhC CRA

A 27-year-old woman taking a combined oral contraceptive is prescribed rifampicin as part of tuberculosis treatment. She asks whether her pill will still work. She has no contraindication to copper intrauterine contraception. What is the most important interaction to flag?

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Correct answer: D — rifampicin can reduce hormonal contraceptive effectiveness through enzyme induction

Rifampicin is a potent enzyme inducer and can markedly reduce the effectiveness of many hormonal contraceptives. A non-hormonal method such as a copper intrauterine device or specialist contraception advice is usually required during and after enzyme-inducing therapy. The interaction is clinically significant because unintended pregnancy may result. It is not a reduction in rifampicin antibacterial activity.

Reference: BNF; FSRH guidance