Medication and contraception advice (teratogenic medication)

Background

You are currently taking a medication which may cause harm to an unborn baby, this is because of an increased risk of birth defects and development disorders when taken during pregnancy, especially during the first trimester (up to week 12 of pregnancy), when you may not know you are pregnant. These are known as teratogenic effects.

The product information for these medicines advise that pregnancy should be avoided during treatment and advise on the need to use suitable contraception whilst taking them. With Sodium Valproate and Topiramate, it is also necessary to have a formal pregnancy prevention programme (PPP) agreement in place which is reviewed annually.

Contraception

The College of Sexual Health and Reproductive Healthcare (CoSRH) advise that women of reproductive age who are taking a known medication with potential teratogenic effects should always be advised to use highly effective contraception both during and for the recommended timeframe after discontinuing medication to avoid unintended pregnancy, along with the following guidance and recommendations.

• Woman should be made aware that no method of contraception is 100% effective.
• “Highly effective” methods of contraception include long-acting reversible contraceptives such as the IUD (intrauterine device or copper coil), IUS (intrauterine system or hormonal coil), contraceptive implant and male sterilisation or female sterilisation. With typical use these have a failure rate of less than 1% and additional contraceptive precautions are not required, unless wanting to reduce the risks further.
• Other methods of contraception include the combined pill, progestogen-only pill (or mini pill) or contraceptive injection. In these situations, it is advised to use additional contraceptive precaution (e.g. condoms).
• The use of barrier (e.g. condoms), withdrawal and fertility awareness methods alone is not recommended.

Pregnancy prevention programme (PPP)

If you are taking Sodium Valproate or Topiramate, a formal pregnancy prevention programme is necessary. These are to ensure that those taking these medications are fully informed of the potential risk and are provided with highly effective contraception to prevent an unplanned pregnancy.

These will be completed annually between the patient and a healthcare professional, either with a specialist or with the GP.

If you are taking one of these medications and you do not currently have a PPP, or you have questions regarding your PPP, please contact the practice to discuss.