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  • Home Office consults on medicinal use of cannabis

    Home Office consults on medicinal use of cannabis

    Friday, 22 June 2018 16:15
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    Measles outbreaks prompt reminder about MMR vaccination ahead of summer holidays

    Friday, 22 June 2018 15:46
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    Smoking levels remain unchanged in Wales at 19%

    Friday, 22 June 2018 15:40
  • GP services get 86% satisfaction rating in Wales

    GP services get 86% satisfaction rating in Wales

    Wednesday, 20 June 2018 18:50
  • NICE guideline says people with dementia should be involved in discussions about their care

    NICE guideline says people with dementia should be involved in discussions about their care

    Wednesday, 20 June 2018 18:47

a woman taking a pillFebruary 16 2018

New guidance has been issued advising about contraceptive options for women taking drugs linked to teratogenicity, or if a male partner is.

The statement by the Faculty of Sexual and Reproductive Healthcare applies to known teratogenic drugs or drugs with potential teratogenic effects. Women taking these medicines (or whose partner is), “should always be advised to use highly effective contraception both during treatment and for the recommended timeframe after discontinuation to avoid unintended pregnancy.”

Details of drugs associated with teratogenicity are listed on the UKTIS (UK Teratology Information Service) website.

The FSRH statement warns: “Advice given in the Summaries of Product Characteristics (SPC) regarding the use of contraception is not consistent for different teratogenic drugs. In some instances, ‘effective contraception’ is recommended. In others, use of ‘two methods of effective contraception’ is advised. Sometimes no advice is given. It is unclear which methods of contraception are considered ‘effective’ or why use of more than one method is sometimes advised.”

Recommendations about advice for women, if they or their male partner is using a teratogenic drug, are to make the patient aware that:

  • no method of contraception is 100% effective;
  • contraception methods considered ‘highly effective’ include the long-acting reversible contraceptives (LARC) copper intrauterine device (Cu-IUD), levonorgestrel intrauterine system (LNG-IUS) and progestogen-only implant (IMP) and male and female sterilisation, all of which have a failure rate of less than 1% with typical use;
  • additional contraceptive precautions (eg condoms or a second effective contraceptive method) are not required if a Cu-IUD, LNG-IUS, IMP or male or female sterilisation is being used;
  • women using hormonal contraception should use additional contraceptive precautions (eg condoms) due to potential failure rates as high as 9% with the oral pill, and 6% with the depot injection of medroxyprogesterone acetate (DMPA);
  • barrier methods, withdrawal or fertility awareness methods used on their own are recommended.

Links:
FSRH announcement    
FSRH CEU ‘Contraception for women using known teratogenic drugs or drugs with potential teratogenic effects’. February 2018.             
UKTIS website   

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