Drug Interactions: Birth Control and Antibiotics - Obstetrics and Gynecology

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Drug interactions


You started taking the contraceptive pill on April 10 for birth control, but on April 16, you developed a stye and visited an ophthalmologist who prescribed a three-day course of cephalexin antibiotics (you continued taking the contraceptive pill).
Should you wait until you finish the three-day course and then wait an additional seven days before having unprotected sex?

Liu Xiaojie, 20~29 year old female. Ask Date: 2020/07/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology


Hello, the following medications can interact with oral contraceptives:
1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol) - may reduce the intestinal 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.
Tuberculosis medications (Rifampicin, Isoniazid).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid (Vitamin C) - may inhibit the metabolism of estrogen, leading to increased concentrations in the body and a higher incidence of side effects.
7.
Oral contraceptives can affect the action of anticoagulants.
8.
Smoking - increases the metabolism of contraceptives, reducing their effectiveness.
Individual metabolic responses vary, and there is currently no conclusion regarding insufficient contraceptive effectiveness within a few days after stopping the medication.
Therefore, it is recommended to continue taking the pills as scheduled.
If menstruation does not occur as expected, a pregnancy test should still be conducted.
Additionally, if it has been since April, multiple cycles should have passed, and other considerations should be taken into account.
Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2020/07/19

More Info


When it comes to understanding drug interactions, particularly between antibiotics and birth control pills, it's essential to consider the specific medications involved and their potential effects on contraceptive efficacy. In your case, you are taking Yaz (also known as drospirenone and ethinyl estradiol), a combination oral contraceptive, and you have been prescribed cephalexin, an antibiotic, for a stye.

The concern about antibiotics affecting the effectiveness of birth control pills primarily stems from the belief that certain antibiotics can reduce the hormonal levels in the bloodstream, thereby diminishing the contraceptive effect. However, the majority of antibiotics, including cephalexin, do not have this effect. The only antibiotic that has been shown to significantly interact with hormonal contraceptives is rifampin, which is used to treat tuberculosis and some other infections.
According to current medical guidelines and research, cephalexin does not interfere with the effectiveness of Yaz or other combined hormonal contraceptives. Therefore, you can continue to rely on your birth control pill for contraception while taking cephalexin.
However, it is always prudent to follow some best practices when taking antibiotics and hormonal contraceptives:
1. Consistency is Key: Continue taking your birth control pill at the same time every day, even while on antibiotics. This helps maintain stable hormone levels in your body.

2. Use Backup Methods: While cephalexin does not affect the efficacy of Yaz, if you have any concerns or if you are taking any other medications that might interact, using a backup method (like condoms) during the course of the antibiotic treatment can provide additional peace of mind.

3. Consult Your Healthcare Provider: If you have any doubts or experience any unusual symptoms, it’s always best to consult your healthcare provider. They can provide personalized advice based on your medical history and current medications.

4. Monitor for Side Effects: While on antibiotics, be aware of any side effects that may occur. Some women may experience changes in their menstrual cycle or spotting while on antibiotics, but this is usually not a sign that the birth control is ineffective.

5. Follow Up: After completing your course of antibiotics, you do not need to wait an additional seven days before relying solely on your birth control pill again, as long as you have taken your pill consistently and correctly.

In summary, you can feel confident that taking cephalexin will not compromise the effectiveness of your Yaz birth control. Continue to take your contraceptive as prescribed, and if you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider for clarification.

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