Leprosy: rifampicin and oral contraceptives: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Leprosy: rifampicin and oral contraceptives

Sample item

A young woman on multibacillary therapy for leprosy is using combined oral contraceptive pills. What advice is correct?

AThe pill is unaffected by the antileprosy drugs, so no change is neededBRifampicin induces liver enzymes and can lower pill efficacy, so add a barrier methodCClofazimine raises oestrogen levels, so the pill dose should be halvedDDapsone makes the pill unsafe, so it must be stopped for life

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Rifampicin induces liver enzymes and can lower pill efficacy, so add a barrier method

Rifampicin is a strong inducer of cytochrome P450 enzymes and increases the metabolism of oestrogens and progestogens, which can cause contraceptive failure. An additional barrier method is advised during treatment.

Option by option

A. The pill is unaffected by the antileprosy drugs, so no change is needed
This is wrong because rifampicin has a well-known interaction with hormonal contraceptives.
B. Rifampicin induces liver enzymes and can lower pill efficacy, so add a barrier method (correct)
Correct. Enzyme induction by rifampicin can reduce contraceptive efficacy.
C. Clofazimine raises oestrogen levels, so the pill dose should be halved
Clofazimine does not raise oestrogen levels, and no pill dose halving is advised.
D. Dapsone makes the pill unsafe, so it must be stopped for life
Dapsone does not make oral contraceptives unsafe and does not require lifelong cessation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Rifampicin induces liver enzymes and can lower pill efficacy, so add a barrier method. Rifampicin is a strong inducer of cytochrome P450 enzymes and increases the metabolism of oestrogens and progestogens, which can cause contraceptive failure.

Why is "The pill is unaffected by the antileprosy drugs, so no change is need…" not the answer?

This is wrong because rifampicin has a well-known interaction with hormonal contraceptives.

Why is "Clofazimine raises oestrogen levels, so the pill dose should be halved" not the answer?

Clofazimine does not raise oestrogen levels, and no pill dose halving is advised.

Why is "Dapsone makes the pill unsafe, so it must be stopped for life" not the answer?

Dapsone does not make oral contraceptives unsafe and does not require lifelong cessation.

What concept does this question test?

It tests Leprosy: rifampicin and oral contraceptives in Dermatology. An additional barrier method is advised during treatment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Leprosy: rifampicin and oral contraceptives?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.