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Carbamazepine and contraception — GPhC CRA MCQ

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HardDrug InteractionsCarbamazepine and contraceptionGPhC CRA

A 27-year-old woman taking carbamazepine had unprotected intercourse 96 hours ago. She has taken carbamazepine continuously for six months and requests emergency contraception. Which option is most appropriate?

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Correct answer: DUrgent copper IUD assessment because enzyme induction does not reduce efficacy

A copper IUD is the most effective emergency contraception, can be fitted within the relevant five-day window and is unaffected by enzyme induction. Carbamazepine reduces exposure to oral hormonal emergency contraception; ulipristal acetate is not recommended with current or recent enzyme-inducing treatment. If a copper IUD is declined or unsuitable, the oral alternative and dose must be selected using current FSRH advice rather than assuming standard-dose efficacy.

Reference: FSRH/CoSRH Guideline: Emergency Contraception: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf