Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which drug has been commonly asked to interfere with oral contraceptive pills (OCPs)?

Rifampicin
Penicillin
Metronidazole
Amoxicillin

The correct answer is: Rifampicin

Rifampicin is known to induce cytochrome P450 enzymes in the liver, specifically CYP3A4, which plays a crucial role in the metabolism of various drugs, including oral contraceptive pills (OCPs). When rifampicin is administered alongside OCPs, it can increase the metabolic breakdown of the hormones contained in the contraceptives, leading to reduced effectiveness and a higher risk of unplanned pregnancies. This interaction is significant enough that healthcare providers often recommend alternative or additional forms of contraception when a patient is prescribed rifampicin. In contrast, the other drugs listed, such as penicillin, metronidazole, and amoxicillin, do not demonstrate a similar effect on the metabolism of hormonal contraceptives and are not commonly associated with diminishing their efficacy. Therefore, rifampicin is the drug most frequently noted for its interference with OCPs.