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UKMEC epilepsy no enzyme inducer — DFSRH MCQ

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HardUKMECUKMEC epilepsy no enzyme inducerDFSRH

A 27-year-old with epilepsy controlled on levetiracetam wants an etonogestrel implant. She stopped carbamazepine 5 weeks ago, has used condoms consistently since, and pregnancy can be excluded. Which advice is correct?

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Correct answer: D — Insert the implant because the carbamazepine precaution interval has passed

The best answer is “Insert the implant because the carbamazepine precaution interval has passed”. Levetiracetam is not an enzyme-inducing antiseizure medicine and does not reduce implant effectiveness. Enzyme-induction precautions are continued for 28 days after stopping the inducer; five weeks have passed. With pregnancy reasonably excluded, the implant can be inserted without inventing a permanent restriction, duplicate implant or prolonged delay.

Reference: CoSRH/FSRH, Progestogen-only Implant: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-progestogen-only-implants.pdf