Contraception in case of the intake of Orkambi® or the like

Question

My daughter (20 yrs) takes part in a Vertex study, the drug is similar to Orkambi®. For contraception, the pill and all other hormone-based devices, are not suitable. How can she do an effective contraception without being afraid of getting pregnant? The gynecologist has no understanding for her situation and is recommending only the pill.

Answer

Dear questioner,
It is indeed a problem, to have a secure contraception, if no hormones are allowed to take. After having read the information about Orkambi® (is she taking it or something else?) I can say, that the effect of the pill can be reduced. We have here a similar situation as with different drugs against HIV. These do probably influence the effect of the pill also, however in everyday life seem to be quite safe. Now, this is unfortunately not 100% and the drug is probably to new in order to get areliable answer. Therefore hormonal based contraception devices are not suitable.
Does your daughter also need the pill in order to get her menstruation regularly? In this case she should go on taking the pill and use additinally condomes. As preparation would then rather a high-dosage so-called one phase preparation most suitable (e.g. Microgynon®).
The copper intrauterine device would theoretically be a possibility, however in women, who have not been pregnant so far, the hormone intrauterine device should be preferred. This device, however, would also be due to the drug not totally safe.
It is a difficult situation and a personal date would be for sure better.

Best regards,

Dr. A.-U. Stücker

25.04.2016