MCQ MAHE 2000 Pharmacology Answer 01
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Use of oral antibiotics in particular metronidazole, amoxicillin, ampicillin, and tetracycline, have been associated with case reports of COC pill failure while taking these and other antibiotics.
Interacting Drug | Possible Effect | Recommendation |
Rifampin | Demonstrated compromised OCP efficacy | Consensus that use of this potent hepatic enzyme inducer requires alternative contraception |
| Griseofulvin | Hepatic enzyme inducer | Demonstrated compromised OCP efficacy |
| Ketoconazole, itraconazole, fluconazole | Inhibitors of hepatic enzymes | Increased levels of EE, delayed withdrawal bleeding. Chronic use could decrease efficacy. |
| Phenobarbitol, primidone, phenytoin, carbamazepine, felbamate, oxcarbazepine, topiramate, vigabatrin, primidone, ethosuximide, modafinil. lamotrigine | Reduced steroid levels. Hepatic mfo enzyme inducers. | No data have demonstrated reduced suppression of ovulation but caution still strongly advised |
| Troglitazone, cycloporine | Hepatic mfo inducers | Possibly reduce pill efficacy |
| Diazepam, chlordiazepoxide, tricyclic antdepressants, theophylline, buprenorphine | Prolonged elimination half-life and increased plasma levels of these agents | Suggest lower doses may achieve desired therapeutic effect in OCP users |
| Acetaminophen, aspirin | Increased clearance of NSAIDS | Some clinicians believe higher doses of NSAIDS may be required for adequate therapy |
| Some antiretroviral drugs: nelfinavir, ritronavir, amprenavir, and nevirapine | Hepatic mfo inducing so increased progestin metabolism | Could decrease COC efficacy |
| St. John’s wort | Inhibitor of cytochrome P450 isoenzymes | Breakthrough bleeding |
| Valproic acid, gabapentin, tiagabine | No change | OCP efficacy unchanged, seizures could still change from EE use |
| Tetracycline, doxycycline, ampicillin, metronidazole, quinolone | Rare case report | Consensus that risk is not increased if only monotherapy and COC pill. POP risk much greater since lower progestin level |
| Acyclovir and AZT related drugs, Indinavir, Saquinavir | None documented | Can be used with OCPs |
*The information on this table was obtained from the Micromedex.com site September 2004
Tags: MCQ, Pharmacology, Drug Interactions, OCP
Category: MAHE 2000 MCQs
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