On Birth Control? Watch Out for These Medications

Simple Health

While birth control is safe to take with most medications, it is known to have negative reactions with some medicines. Hormonal birth control emits the hormones progestin and estrogen into the human body—hormones that are processed by our P450 enzyme system. Medicines that speed up or slow down this enzyme system will cause the body to metabolize birth control differently. Here’s a comprehensive list of those medications.

  1. Antibiotics: Most antibiotics are absolutely fine to take with hormonal birth control, especially the common ones you might take to treat your acne, sore throat, UTI, or vaginal infection. The one important caveat is the medication Rifampin, or Rifabutin, an antibiotic used to treat tuberculosis or meningitis. There is evidence that Rifampin interferes with the effectiveness of the pill; however, a typical course of antibiotics for tuberculosis treatment will only last 6-9 months, during which time you can use alternate birth control methods.
  2. Anticonvulsants / Mood stabilizers: If you have epilepsy or bipolar disorder, make sure you speak to your doctor about your medication’s possible interaction with hormonal birth control. Barbiturate medicines commonly used as anticonvulsants, sleep aids, and mood stabilizers have been known to interfere with birth control (this includes Felbatol, Lamictal, Luminal, Solfoton, and Mysoline). Other medicines for treating seizures and nerve pain, like Trileptal, Tegretol, Carbatrol, Equetro, Epitol, Dilantin, Phenytek, and Topomax, are also known to make birth control less effective. Unfortunately these negative interactions are a two-way street, meaning that these medications weaken the effects of birth control and birth control weakens the effects of these medications. In any case, if you are on a mood stabilizer or anticonvulsant and want to prevent pregnancy, talk to your doctor about possible birth control options.
  3. HIV Medication: Some anti-HIV protease inhibitors are known to make hormonal birth control less effective. Some examples of these drugs are Nelfinavir, Nevirapine, and Ritonavir-boosted inhibitors such as Tipranavir, Lopinavir, Fosamprenavir, and Darunavir. Luckily, there are some antiretroviral drugs that won’t interfere with the pill’s effectiveness, such as Tenofovir, so people with HIV can receive treatment and stay pregnancy-free.
  4. St. John’s Wort: St. John’s wort is an herbal supplement that some people take to treat depression, insomnia, or anxiety. It reduces the concentration of progestin and estrogen in a birth control pill by 15%, altering the hormonal dose enough to cause breakthrough bleeding (this is bleeding that occurs outside the birth control’s allotted period). While the jury is still out on how St. John’s wort affects one’s chances of getting pregnant while on the pill, it certainly interferes with the pill’s hormone dose and should not be taken if you want to ensure birth control efficacy.
  5. Antidepressants: To date, the science has shown that antidepressants and birth control are fine to take together. For example, if you’re on the pill and you start taking Prozac, you’re not going to get pregnant. That being said, antidepressants can affect your hormone levels, interacting with your hormonal birth control, which could have effects outside of efficacy, like an impact on mood or anxiety (the level of interaction will differ from person to person). One thing to watch out for is if you’re on mood-stabilizing or anti-seizure medication for your depression (such as Lamotragene, Tegretol, or Topomax), which can impact the efficacy of your birth control. Every case will be a little different, which is it’s best to consult with your doctor first.
  6. Antifungal medications: Some antifungal medications have been known to interfere with the efficacy of birth control. There are two kinds of medications shown to have these effects. The first kind involves Nilstat, Nystex, and Mycostatin—used to treat yeast infections—and the second kind involves Grisactin, Grifulvin V, Gris-Peg, and Fulvicin—used to treat fungal infections like ringworm, jock itch, and athlete’s foot.
  7. Diabetes medications: Not a great deal is known about interactions between hormonal birth control and diabetes medication, but two drugs, Actos and Avandia, may negatively interfere.
  8. Anti-anxiety medications: Similarly to diabetes medication, not much is known about anti-anxiety medication and birth control interactions; however, some medicines that treat anxiety, sleeping issues, or muscle spasms, such as Valium, Restoril, and Diastat, are thought to potentially interfere with birth control efficacy.
  9. Pulmonary Arterial Hypertension Medication (Tracleer): If you have pulmonary arterial hypertension (high blood pressure of the lung vessels) and are taking Tracleer, you should absolutely consult with a doctor before using birth control. Tracleer decreases the concentration of hormones in the bloodstream, decreasing the efficacy of your birth control and increasing your risk of pregnancy. Tracleer can also cause severe birth defects if taken during pregnancy—another reason to talk to your doctor and make sure your birth control works for you if you have PAH.
  10. Anti-nausea medication (Emend): Emend is a medicine that prevents and treats vomiting and nausea, and it can interfere with birth control. As a general note, vomiting will negatively impact the effectiveness of oral contraceptives, as the body won’t be able to fully absorb the pill if vomiting occurs within two hours of taking it. If you’re prone to nausea and vomiting, talk to your doctor about your birth control options, as the pill might not be your best choice.
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