1.

Separate the oral ingestion of the rifampin and oral contraceptive by at least an hour.

2.

Both medications are best tolerated if taken on an empty stomach.

3.

She should use a back-up method of birth control such as condoms for the rest of the current pill pack.

4.

If she gets nauseated with the medications she should call the office for an antiemetic prescription.

1.

Low-dose oral estrogen

2.

A low-dose estrogen/progesterone combination

3.

A vaginal estradiol ring

4.

Vaginal progesterone cream

1.

Depression

2.

Hypertension

3.

Weight loss

4.

Cataracts

1.

Hypertension and dysuria

2.

Depression and weight gain

3.

Abdominal pain and constipation

4.

Orthostatic hypotension and dermatitis

1.

The potential development of significant hypertension

2.

Increased risk of strokes

3.

Decreased bone density

4.

The risk of a life-threatening rash such as Stevens-Johnson

1.

Reassurance that some spotting is normal the first few months of Depo and it should improve.

2.

Schedule an appointment for an exam as this is not normal.

3.

Prescribe 4 weeks of estrogen to treat the abnormal vaginal bleeding.

4.

Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot.