The effectiveness of both combined and progestogen-only oral contraceptives can be considerably reduced by interaction with drugs that induce hepatic enzyme activity; refer to BNF for further information. Consider barrier methods of contraception where appropriate in association with contraception to prevent infection. For information on the use of co-cyprindiol in acne refer to Preparations for acne and rosacea.
- further information on contraceptive methods at https://www.fsrh.org/standards-and-guidance/current-clinical-guidance/
- medical eligibility criteria for contraceptive use: https://www.fsrh.org/standards-and-guidance/uk-medical-eligibility-criteria-for-contraceptive-use-ukmec/
- missed pill recommendations: see guidance and FSRH CEU Guidance: Recommended Actions after incorrect Use of Combined Hormonal Contraception (eg late or missed pills, ring and patch) (March 2020)
Note: Contraceptives containing desogestrel or gestodene may be considered for women unable to tolerate other progestogens. Advise patients that desogestrel and gestodene have been associated with an increased risk of venous thromboembolism.
MHRA advice: Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? (March 2019) (www.gov.uk).
FSRH CEU Guidance: Drug Interactions with Hormonal Contraception (May 2022).
SPS article: What is a suitable combined oral contraceptive pill in a patient who is taking hepatic enzyme-inducing drugs, such as carbamazepine, phenytoin, rifampicin or rifabutin? (May 2019).