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Implant with carbamazepine — DFSRH MCQ

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HardProgestogen-only methodsImplant with carbamazepineDFSRH

A 26-year-old with focal epilepsy controlled on carbamazepine requests a contraceptive implant. She has regular sex with a male partner and does not use condoms. BMI is 23 kg/m2 and pregnancy test is negative. What is the most appropriate contraceptive method?

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

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Correct answer: B — Copper IUD or DMPA injection

Carbamazepine is an enzyme inducer that can reduce effectiveness of the implant, POP and CHC. Copper IUD and DMPA are not affected by enzyme induction and are preferable for reliable contraception. Reliance on repeated oral EC is inferior and enzyme induction also reduces oral EC options.

Reference: FSRH Guideline Drug Interactions with Hormonal Contraception; FSRH Progestogen-only Implant