Questions Flashcards
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A 19-year-old woman has recently been prescribed Microgynon® 30 tablets (ethinylestradiol /
levonorgestrel). She suffers from several medical conditions and wants to know whether these tablets are
safe for her to take.
Which one of the following conditions is most likely to be a contra-indication for combined oral
contraceptives?
a. asthma
b. diabetes
c. eczema
d. hypertension
e. hyperthyroidism
Combined oral contraceptives (COC) are contra-indicated in hypertension (blood pressure systolic
160 mmHg or diastolic 100 mmHg or higher), The risk of arterial thromboembolic complications or of a
cerebrovascular accident in COC users increases in women with risk factors, such as hypertension.
The SPC for Microgynon 30 states: Although small increases in blood pressure have been reported in many
women taking COCs, clinically relevant increases are rare. However, if sustained hypertension develops
during the use of a COC, antihypertensive treatment should normally be instigated at a level of 160/100 mm
Hg in uncomplicated patients or at 140/90 mm Hg in those with target organ damage, established
cardiovascular disease, diabetes or with increased cardiovascular risk factors. Decisions about the
continued use of the COC should be made at lower BP levels, and alternative contraception may be advised.
