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Bisphosphonate counselling — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsBisphosphonate counsellingGPhC CRA

A man taking valproate plans to try for a pregnancy with his partner in six weeks and asks whether he can stop the medicine tonight. What counselling is most accurate?

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Correct answer: AContinue treatment pending review and use contraception for three months after cessation

MHRA precautionary advice recommends effective contraception during paternal valproate exposure and for at least three months after stopping to allow a sperm-development cycle without exposure. Men planning a family should receive specialist review of alternatives, but valproate must not be stopped abruptly because seizure or disease control may deteriorate. The advice concerns both the man and partner and cannot be met by self-directed switching.

Reference: MHRA: valproate use in men. https://www.gov.uk/drug-safety-update/valproate-use-in-men-as-a-precaution-men-and-their-partners-should-use-effective-contraception