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Enzyme-inducing medication and contraception — DRCOG MCQ

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HardContraception and Sexual HealthEnzyme-inducing medication and contraceptionDRCOG

A 31-year-old woman taking carbamazepine for epilepsy requests a progestogen-only pill. She has no current contraception and wants a reliable method. She has no plans for pregnancy. What would you advise?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Use a method unaffected by enzyme induction such as copper IUD or depot injection

Carbamazepine is an enzyme inducer and can reduce effectiveness of many hormonal methods, including POPs and implants. Methods such as copper IUD, levonorgestrel IUD or depot injection are preferred depending on eligibility, with copper IUD completely unaffected by enzyme induction. A patch is also affected by enzyme induction. The pearl is to check interactions before prescribing contraception.

Reference: FSRH UKMEC; FSRH drug interactions guidance; BNF