Do Antibiotics Affect Birth Control Pills? A Doctor's Insight

Birth control pills and antibiotics?

Hello Dr.
Chang, I have been taking the contraceptive pill for five months.
I have been taking it on schedule this month as well, but due to a toothache, my dentist prescribed antibiotics for me, which I took one in the morning and one in the evening.
Unfortunately, I had sexual intercourse on December 31, which was the ninth day of my contraceptive pill regimen.
I would like to know if the two antibiotics I took that day could affect the effectiveness of the birth control pill.
Additionally, I have been experiencing some lower abdominal discomfort and breast swelling in the past few days, and I am very concerned about the possibility of being pregnant.

Cherry, 30~39 year old female. Ask Date: 2017/01/14

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the following medications may interact with oral contraceptives:
1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol) - may reduce the gut flora that aids in absorption, thereby decreasing the effectiveness of contraceptives.
2.
Sedatives (Barbiturates) - increase the metabolism of contraceptives, reducing their effectiveness.
3.
Antiepileptic drugs (Primidone, Phenytoin, Carbamazepine) - increase the metabolism of contraceptives, reducing their effectiveness.
4.
Antituberculosis medications (Rifampicin, Isoniazid).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid (Vitamin C) - may inhibit estrogen metabolism, leading to increased serum levels and a higher incidence of side effects.
7.
Oral contraceptives may affect the efficacy of anticoagulants.
8.
Smoking - increases the metabolism of contraceptives, reducing their effectiveness.
It is recommended that if your menstrual period is more than a week late, you should check for pregnancy.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2017/01/14

More Info

When it comes to the interaction between antibiotics and birth control pills, it is essential to understand the nuances involved. Generally, most antibiotics do not significantly affect the efficacy of hormonal contraceptives, such as birth control pills. However, there are exceptions, and it is crucial to consider the specific antibiotic prescribed.

The most commonly discussed antibiotic in this context is rifampin, which is known to reduce the effectiveness of birth control pills. Rifampin works by inducing liver enzymes that metabolize hormones more quickly, potentially leading to decreased hormone levels in the bloodstream. This can result in breakthrough bleeding or unintended pregnancy. Fortunately, most antibiotics, including those typically prescribed for dental infections, such as amoxicillin or clindamycin, do not have this effect.

In your case, since you mentioned taking antibiotics for dental pain, it is likely that the antibiotic prescribed was not one that significantly interferes with the effectiveness of your birth control pill. However, it is always wise to consult with your healthcare provider or pharmacist regarding the specific antibiotic you were prescribed to confirm its interaction with your contraceptive method.

Regarding your concerns about potential pregnancy, it is important to note that the timing of your antibiotic intake and the use of your birth control pill plays a crucial role. Since you mentioned that you were on the ninth day of your pill regimen when you had unprotected intercourse, and if the antibiotic you took does not interfere with the pill's effectiveness, the likelihood of pregnancy remains low. However, if you are experiencing unusual symptoms such as abdominal discomfort and breast tenderness, it may be worth taking a pregnancy test for peace of mind.

It is also essential to remember that while hormonal contraceptives are highly effective, no method is 100% foolproof. Factors such as missed pills, gastrointestinal issues (like vomiting or diarrhea), or interactions with other medications can impact their efficacy. If you have concerns about your birth control method or experience any side effects from the antibiotics, discussing these with your healthcare provider is advisable.

In summary, while most antibiotics do not affect the efficacy of birth control pills, it is crucial to be aware of the specific antibiotic you are taking. If you have any doubts or experience concerning symptoms, consulting with your healthcare provider is the best course of action. They can provide personalized advice based on your medical history and current situation, ensuring you have the most accurate information regarding your reproductive health.

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