What are the key contraindications for prescribing progestogen-only pills (POP) in women of reproductive age?

When considering progestogen-only pills (POPs) for women of reproductive age, suitability is assessed by checking the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) ¹. While the UKMEC provides comprehensive guidance, specific contraindications are highlighted for drospirenone, a type of POP ¹,².

Key contraindications for drospirenone-containing POPs include:

• Severe renal insufficiency ¹,².
• Acute renal failure ¹,².
• Known hyperkalaemia ¹,².
• Untreated hypoaldosteronism ¹,².
• Concurrent use of potassium-sparing diuretics or potassium supplements ¹,².

For individuals with mild or moderate renal insufficiency or treated hypoaldosteronism, or those with significant risk factors for chronic kidney disease (especially over 50 years), monitoring of urea and electrolytes and blood pressure may be required when drospirenone is used ¹,². It is also important to consider potential drug interactions with POPs ¹.