Enzyme-inducing antiepileptic contraception — DFSRH MCQ

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HardPharmacology of hormonal contraceptionEnzyme-inducing antiepileptic contraceptionDFSRH

A patient taking carbamazepine wants a non-injectable contraceptive method and reports heavy periods. Which option is both reliable with enzyme induction and likely to improve bleeding?

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Correct answer: C — A 52 mg LNG-IUD

Carbamazepine can reduce the effectiveness of the implant, progestogen-only pills and combined hormonal contraception. A 52 mg LNG-IUD is not expected to be affected by enzyme induction and can reduce menstrual bleeding, making it the best fit for this presentation.

Reference: CoSRH/FSRH, Drug interactions with hormonal contraception: https://www.cosrh.org/Common/Uploaded%20files/documents/drug-interactions-with-hormonal-contraception-5may2022.pdf