Introduction
Birth control failure is a serious problem that needs to be considered as it results in a higher risk of unplanned pregnancies. In addition, some medications interfere with the effectiveness of birth control pills. Therefore, certain medications should be avoided for better effectiveness of the hormonal pills. Any type of birth control method contains estrogen and progesterone hormones; these prevent eggs from getting released from the ovary, thereby preventing pregnancy. But certain medications, when taken alone with the birth control pill, will not allow the hormone to do its job, thus reducing its efficacy.
What Are the Medications That Interact With the Contraceptive Pills?
Antibiotics:
Many antibiotics are prescribed for treating various conditions. Not all antibiotics reduce the effect of the contraceptive pill. Of those contraceptive pills that contain Ethinyl estradiol, most antibiotics reduce their efficacy. Rifampin is an antibiotic that usually interferes with the contraceptive pill's effectiveness. These alter the stomach environment and cause reduced absorption of the contraceptive pills. Rifampin is used in the treatment of tuberculosis. These medications cause irregular periods, which increases the risk of pregnancy even under the proper intake of birth control pills.
Rifampin reduces the efficacy of birth control pills by:
Rifampin reduces efficacy by reducing the birth control hormone level in women taking contraceptive pills required to prevent ovulation.
Rifampin can be responsible for breaking down estrogen faster than usual by producing enzymes responsible for the breakdown in the liver. Therefore, it reduces the hormonal level and decreases the efficacy of the birth control pill.
Rifampin can also reduce the effectiveness of vaginal rings and transdermal birth control patches, so alternative birth control methods should be used.
A non-hormonal birth control method should be used during Rifampin intake.
Anti-HIV Drugs:
Some antiretroviral drugs used to treat HIV (human immunodeficiency virus) can reduce the effectiveness of contraceptive pills. The person should consult a doctor before taking any antiviral drug to treat HIV when under birth control pill therapy.
Anti-fungal Medication:
Certain oral or intravenous antifungal medications can reduce the effectiveness of birth control pills. For example, Griseofulvin and Ketoconazole usually decrease the efficacy of contraceptive pills. Griseofulvin treats skin infections such as athlete’s foot and jock itch, whereas Ketoconazole is an alternative medication when other antifungal drugs are ineffective. Women should switch to other birth control methods for a month after a dose of Griseofulvin. Anti-fungal ointments, creams, or powders applied topically do not interfere with contraceptive pills.
Antifungals such as Fluconazole and Itraconazole prevent the enzyme from metabolizing the birth control pill. This results in an increased concentration of estrogen in plasma that leads to nausea and breast tenderness. Short-term use of antifungals does not lead to any major issues, but long-term use results in many concerns.
Anticonvulsants:
Anticonvulsants are medications used in treating seizures; these are known to interfere with the effectiveness of birth control pills. For example, Topamax, usually used to treat seizure and prevents migraine, interferes with birth control pills and reduces their effectiveness. Other anticonvulsant medications that interfere with birth control pills include:
Tegretol.
Dilantin.
Phenobarbital.
Trileptal.
Lamictal.
If a person uses anticonvulsants, other forms of birth control, such as an IUD (intrauterine device), a diaphragm, or a condom, should be used.
General Anesthesia:
If there is any procedure or surgery to be done that requires anesthesia, the surgeon should be informed about the type of contraceptive used, as general anesthesia can interfere with its effectiveness. Sugammadex reverses the neuromuscular blockages associated with the surgical procedure. However, one of the side effects of Sugammadex is that it binds to and temporarily inhibits the functions of birth control pills. Therefore, women should take up a non-hormonal backup for seven days after the administration of Sugammadex.
Anti-emetic Medications:
Emend medication blocks chemicals responsible for nausea, which can reduce the effectiveness of birth control pills. Therefore, women should switch to non-hormonal backup for about a month after taking Emend.
If a person vomits soon after taking a birth control pill, it means the pill is not completely absorbed, so there may be chances of pregnancy. To avoid any pregnancy, another pill should be taken.
Pulmonary Hypertension Medications:
Tracleer is a medication used to treat high blood pressure in the lungs, which can interfere with the birth control pill's effectiveness by reducing the hormonal levels in the blood. It may also lead to the risk of severe birth defects, so it is advised that any woman taking this medication use two birth control methods. People can seek help from doctors when choosing two methods of birth control.
Diabetes Medications:
Pioglitazone or combination drugs that contain Pioglitazone may interfere with the effectiveness of birth control pills. Seek help from an endocrinologist or gynecologist to find an alternative treatment method. Women under birth control pills should shift to a non-hormonal birth control method for a month after intake of Pioglitazone.
Herbal Supplements:
St. John’s Wort - This supplement is recommended as it helps to deal with the symptoms of depression, insomnia, or anxiety. However, it is seen that St. John’s wort used to treat depression contains ingredients that may enhance the breakdown of estrogen, causing less effective birth control therapy.
Vitamin C:
Vitamin C supplements are taken to improve immune function and can reduce the efficacy of birth control pills. In addition, a high dose of vitamin C increases estrogen, which may cause problems.
Melatonin:
Melatonin, which is taken during the night and helps with sleep or jet lag, can interfere with birth control pills, but there is no evidence. It is better to take advice from the doctors before taking these supplements along with birth control pills.
NSAIDs (Non-Steroidal Anti-inflammatory Drugs):
If the oral contraceptive contains Progestin drospirenone, the NSAIDs Ibuprofen or Naproxen should be taken with a consultation. This is because the regular everyday intake of these medications and Drospirenone raises the blood's potassium level, resulting in heart problems and other health issues. In addition, some medications, such as Tylenol and Sudafed, do not interact with birth control pills.
Laxatives:
Taking laxative or products like detox teas enhance the frequency of bowel movements and can decrease the efficacy of birth control pills. This is because such products decrease the absorption of contraceptive pills. So, in the case of laxatives and birth control pills, a non-hormonal backup should be used.
Conclusion
Birth control pills are methods to prevent pregnancy, but the effectiveness of these pills can be interfered with or reduced by the intake of other medications. For example, their efficacy reduces due to less absorption by the body or by reducing the hormone level in the blood required to prevent pregnancy. In addition, certain medications interfere with their effectiveness, so a non-hormonal birth control method should be used in adjunct to the pills. So, before combining any medications with contraceptive pills, a recommendation from a doctor is needed.
