additional contraceptive precautions if stopped hepatic enzyme inducer but continue combined oral contraceptive (COC) pill
Last edited 05/2019
- enzyme inducers and the combined pill
- enzyme activity does not return to normal for several weeks after
stopping an enzyme-inducing drug - therefore appropriate contraceptive
measures are required for 4 weeks for the liver enzymes to return to normal
functionality (1)
- therefore higher doses of the COC, with or without additional contraceptive
protection, should be continued for 4 weeks after stopping the AED
(2)
- this period should be increased to 8 weeks after more prolonged
used of enzyme inducers. In all cases, the PFI should be omitted
when switching back to a standard or low-dose COC (2)
- this period should be increased to 8 weeks after more prolonged
used of enzyme inducers. In all cases, the PFI should be omitted
when switching back to a standard or low-dose COC (2)
- therefore higher doses of the COC, with or without additional contraceptive
protection, should be continued for 4 weeks after stopping the AED
(2)
- enzyme activity does not return to normal for several weeks after
stopping an enzyme-inducing drug - therefore appropriate contraceptive
measures are required for 4 weeks for the liver enzymes to return to normal
functionality (1)
Reference:
- Faculty of Sexual & Reproductive Healthcare Clinical Guidance.Clinical Guidance: Drug Interactions with Hormonal Contraception January 2018.
- NHS Specialist Pharmacy Service (May 2019). Which combined oral contraceptive pill is suitable in a patient who is taking hepatic enzyme-inducing drugs, such as carbamazepine, phenytoin, rifampicin or rifabutin?