- A 21yo woman who is on COCP had to take azithromycin. What should be advised for her
contraception?
a. Using 7d condoms after antibiotics and avoid pill free break
b. Using 14d condoms after antibiotics and avoid pill free break
c. Using 7d condoms after antibiotics
d. No extra precaution
e. Using 14d condoms after antibiotic
Answer: D
The danger with COCP is enzyme inducers which can lower the levels of the hormone in he blood, azithromycin is not an enzyme inducer! FSRH guidance now no longer advises that additional precautions are required to maintain contraceptive efficacy when using antibiotics that are not enzyme inducers with combined hormonal methods for durations of 3 weeks or less. The only proviso would be that if the antibiotics (and/or the illness) caused vomiting or diarrhoea, then the usual additional precautions relating to these conditions should be observed
Inducers: decrease conc of drug in blood…RASAG
rifampicin
anticonvulsants, particularly phenytoin, carbamazepine, phenobarbitone and primidone
spironolactone, st johns wort
alcohol, long term
griseofulvin