Patients who should avoid oral contraceptives and who should employ alternative contraceptive measures:
(1) a patient with a previous history of a thrombotic event
(2) a patient with a strong family history for thrombotic events
In a woman whose past history is unclear or whose familiar history for thrombosis is uncertain, then the patient should be screened for:
(1) factor S deficiency
(2) factor V Leiden (using activated protein C resistance)
(3) prothrombin G20210A
Although not listed by the authors, I would also screen for factor C and antithrombin III deficiency
If the person shows a deficiency in one or more of these factors, then oral contraceptive agents should not be used.
If a woman develops a thrombotic event while on oral contraceptives:
(1) the oral contraceptive therapy should be stopped
(2) she should be switched to an alternative contraceptive method
(3) she should be evaluated for thrombophilic defect
