If a woman on oral contraceptives begins TB preventive treatment, what is the recommended action?

When a woman on oral contraceptives begins TB preventive treatment, the recommended action is to change to another form of contraceptive or to choose pills with a higher estrogen dose. This is because certain TB medications, particularly rifampicin, can significantly reduce the effectiveness of standard oral contraceptives. Rifampicin induces liver enzymes that metabolize hormones in the contraceptives, leading to lower levels in the bloodstream and potentially increasing the risk of unintended pregnancy.

Changing to another form of contraception that is not affected by rifampicin or transitioning to pills with a higher estrogen dose can help ensure that contraceptive effectiveness is maintained during TB treatment. By making this adjustment, the woman can avoid the risk of contraceptive failure while still receiving the necessary treatment for tuberculosis. This action is a proactive measure to ensure both effective TB treatment and continuous contraceptive protection.