Does Taking Antibiotics Affect the Effectiveness of Birth Control Pills?

Taking antibiotics while on pre-exposure prophylaxis (PrEP) for contraception (such as Ella)?

Hello, doctor! I have been taking the emergency contraceptive pill (Yueji) for two boxes and 13 tablets.
Due to a case of tonsillitis, I am also taking medications prescribed by my doctor (Clindamycin, Lysozyme).
In addition, I have been supplementing with a multivitamin (containing Vitamin C and fish oil) and Yakult to increase beneficial gut bacteria.
Will this affect the effectiveness of the emergency contraceptive pill? Additionally, how long should I wait between taking the contraceptive pill and antibiotics for optimal effectiveness? Thank you, doctor!

Xiao Qiao, 20~29 year old female. Ask Date: 2022/04/16

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the following medications may interact with oral contraceptives:
1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol, Doxycycline) can reduce the effectiveness of oral contraceptives.
When taking these medications, alternative contraception methods should be employed, as they may decrease the gut flora that aids in absorption, thereby lowering the efficacy of the contraceptive.
2.
Sedatives (Barbiturates) can increase the metabolism of oral contraceptives, reducing their effectiveness.
3.
Antiepileptic drugs (Primidone, Phenytoin, Carbamazepine) can also increase the metabolism of oral contraceptives, leading to decreased effectiveness.
4.
Tuberculosis medications (Rifampicin, Isoniazid) may interact similarly.
5.
Antidiabetic medications (Rosiglitazone) can have an effect as well.
6.
Acetaminophen and Ascorbic acid (Vitamin C) may inhibit estrogen metabolism, potentially increasing serum levels and the occurrence of side effects.
7.
Oral contraceptives can affect the action of anticoagulants.
8.
Smoking can increase the metabolism of oral contraceptives, reducing their effectiveness.
Therefore, if you need to take any of the aforementioned medications while on oral contraceptives, it is advisable to use additional contraception for at least seven days.

Additionally, long-term consumption of certain teas or herbs may have additive or subtractive effects with oral contraceptives.
Furthermore, any medication should be taken with water and not with beverages like tea or coffee, as this may affect the medication's efficacy.

Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/04/16

More Info

When it comes to the interaction between antibiotics and birth control pills, it's essential to understand how certain medications can affect the efficacy of hormonal contraceptives. The concern primarily arises from the potential for antibiotics to interfere with the metabolism of birth control hormones, leading to reduced effectiveness and an increased risk of unintended pregnancy.

Most antibiotics do not significantly affect the effectiveness of birth control pills. However, there are exceptions, with the most notable being rifampin and rifabutin, which are used to treat tuberculosis and some other infections. These antibiotics can induce liver enzymes that metabolize hormones, thereby reducing the levels of contraceptive hormones in the bloodstream. Clindamycin, which you mentioned taking, is not known to have this effect. Therefore, using clindamycin should not compromise the effectiveness of your birth control pills.

Regarding the use of other medications, such as lysozyme and vitamins, these typically do not interact with hormonal contraceptives. Lysozyme is an enzyme that helps break down bacterial cell walls and is generally considered safe. Vitamins, including vitamin C and fish oil, are also not known to interfere with the effectiveness of birth control pills.

As for the timing of taking antibiotics and birth control pills, there is no specific requirement to space them out. However, it is a good practice to take them at different times of the day if possible, simply to ensure that you remember to take both as prescribed. This can also help minimize any potential gastrointestinal side effects that might arise from taking multiple medications simultaneously.

If you are taking antibiotics for a prolonged period or if you have concerns about your birth control method's effectiveness, it is advisable to use a backup contraceptive method, such as condoms, during this time. This precaution can provide additional peace of mind and help prevent unintended pregnancy.

In summary, taking clindamycin and lysozyme should not affect the effectiveness of your birth control pills. It is always wise to consult with your healthcare provider about any medications you are taking and their potential interactions. They can provide personalized advice based on your health history and current medications. If you have any further concerns or experience any unusual symptoms, do not hesitate to reach out to your healthcare provider for guidance.

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