Table 8  Recommendations about contraception for patients taking enzyme-inducing drugs.

Method	Short-term therapy < 2 months	Long-term therapy > 2 months or difficulty in using additional contraceptive methods
Combined hormonal contraceptives combined oral contraceptive (COC) combined transdermal patch combined vaginal ring	Recommendation: Switch to contraceptive method which is not affected by enzyme-inducing drugs. For example, stop taking COC and use a DMPA depot injection	Switch to a contraceptive method which is not affected by enzyme-inducing drugs
	Alternatives: Take COC/d (30 µg EE/d), hormone patch/1 week or vaginal ring/3 weeks with extended or triphasic dosing and a hormone-free interval of 4 days and additionally use barrier method during enzyme-inducing therapy and for 28 days after ending enzyme-inducing treatment plus: use additional contraceptive method (e.g. condoms) when taking enzyme-inducing drugs and for 28 days after ending treatment with enzyme-inducing medication or: follow the recommendations for long-term therapy with enzyme-inducing drugs	Take COC (at least 50 µg EE) with extended or triphasic dosing and a hormone-free interval of 4 days during enzyme-inducing therapy for 28 days after ending enzyme-inducing treatment Note: This recommendation does not include the enzyme inducers rifampicin and rifabutin! Using 2 patches or rings is not recommended
Progesterone-only therapy oral progesterone pill progesterone implant	Recommendation: Switch to a contraceptive method which is not affected by enzyme-inducing drugs	Switch to a contraceptive method which is not affected by enzyme-inducing drugs
	Alternatives: Continue taking oral progesterone-only pill or progesterone implant and use an additional barrier method during treatment with enzyme-inducing drugs and for 28 days after ending treatment with enzyme-inducing drugs	No alternatives recommended
progesterone injection (DMPA, NET-EN, LNG-IUS)	No changes required	No changes required
Emergency contraception
Copper IUD	Efficacy is unaffected, therefore recommended for all women for whom copper IUD is not contraindicated for the period during which they take enzyme-inducing drugs and for 28 days after ending treatment with enzyme-inducing drugs (0 – 120 h after unprotected SI or within 5 days of expected date of ovulation)
Progesterone-only therapy	3 mg LNG in the form of a single dose to be taken as quickly as possible up to 120 h after unprotected SI (off label)
Progesterone receptor modulator	Use of other methods is recommended
Non-hormonal methods	No changes required