Absolute Contraindications to the Use of OCP - USMLE Forums
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Old 04-19-2010
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Drug Absolute Contraindications to the Use of OCP

This is frequently touched in USMLE CK questions.

Here's a quick list

  • Smoking greater than age 35
  • History of CVA or MI or multiple risk factors for coronary artery disease (older, smoker, hypertension, DM)
  • Moderate or severe hypertension ( baseline BP > 160/100), should also avoid in patients who have more adequately controlled hypertension as risks usually outweigh benefits
  • Diabetes with significant vascular complications
  • Complicated valvular heart disease
  • Thrombophilia or Thromboembolic disorder (history of DVT/PE)
  • Major surgery with prolonged hospitalization
  • Known or suspected pregnancy
  • Undiagnosed vaginal bleeding
  • Known or suspected breast cancer (or history of breast cancer)
  • Markedly abnormal liver function, active viral hepatitis, malignant liver tumor
  • Avoid in patients with symptomatic gall bladder disease current or treated
  • Migraine with focal neurologic symptoms (flashing lights, loss of vision, weakness, slurred speech, dizziness, cranial nerve abnormalities)
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Old 07-13-2010
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really great effort , thnx !
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Old 07-12-2012
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include SLE in absolute contraindication...
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Old 12-12-2013
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Absolute contraindications
  • < 6 wks postpartum
  • smoker over the age of 35 (>15 cigarettes per day)
  • hypertension (systolic > 160mmHg or diastolic > 100mmHg)
  • current of past histroy of venous thromboembolism (VTE)
  • ischemic heart disease
  • history of cerebrovascular accident
  • complicated valvular heart disease (pulmonary hypertension, atrial fibrillation, histroy of subacute bacterial endocarditis)
  • migraine headache with focal neurological symptoms
  • breast cancer (current)
  • diabetes with retinopathy/nephropathy/neuropathy
  • severe cirrhosis
  • liver tumour (adenoma or hepatoma)

Relative contraindications
  • smoker over the age of 35 (< 15 cigarettes per day)
  • adequately controlled hypertension
  • hypertension (systolic 140 - 159mmHg or diastolic 90 - 99mmHg)
  • migrain headache over the age of 35
  • currently symptomatic gallbladder disease
  • mild cirrhosis
  • history of combined OCP-related cholestasis
  • users of medications that may interfere with OCP metabolism

World Health Organization. Improving access to quality care in family planning: medical eligibility criteria for contraceptive use. 2nd ed. Geneva: WHO; 2001.
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Old 06-08-2014
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Relative CIs are really confusing
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