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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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a woman taking a pillFebruary 16 2018

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

The guidance applies to known teratogenic drugs or drugs with potential teratogenic effects. Women taking these medicines “should always be advised to use highly effective contraception both during treatment and for the recommended timeframe after discontinuation to avoid unintended pregnancy.”

The statement has been issued by the Faculty of Sexual and Reproductive Healthcare, a faculty of the Royal College of the Obstetricians and Gynaecologists. 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 a 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, 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 (e.g. 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 statement: ‘Contraception for women using known teratogenic drugs or drugs with potential teratogenic effects’. February 2018.            
UKTIS website  

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