A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient?
a. She may need to increase her dose of phenytoin while taking oral contracep-tives.
b. She should consider a different form of birth control while taking phenytoin.
c. She should remain on oral contraceptives, because phenytoin causes birth defects.
d. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin.
B
Because phenytoin can reduce the effects of oral contraceptive pills (OCPs) and because avoid-ing pregnancy is desirable when taking phenytoin, patients should be advised to increase the dose of oral contraceptives or use an alternative method of birth control. Increasing the patient's dose of phenytoin is not necessary; OCPs do not affect phenytoin levels. Phenytoin is linked to birth defects; OCPs have decreased effectiveness in patients treated with phenytoin, and the patient should be advised to increase the OCP dose or to use an alternative form of birth control. OCPs do not alter the effects of phenytoin.
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