Drug Interactions: Birth Control and Antibiotics

Drug interactions

Hello, I am currently taking the oral contraceptive pill Diane-35 and have completed two packs.
On the seventh day of my seven-day break, I started taking doxycycline (two pills a day) prescribed by my clinic due to a cold.
I plan to return to the ENT specialist on the fourth day of taking the antibiotic.
Can I start a new pack of the contraceptive pill? Will the effectiveness of the contraceptive pill be affected? Do I need any additional contraceptive measures? Thank you.

Ms. Li, 20~29 year old female. Ask Date: 2023/03/26

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 contraceptive 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).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid (Vitamin C) may inhibit estrogen metabolism, potentially increasing its concentration in the body and leading to a higher incidence of side effects.
7.
Oral contraceptives can affect the action of anticoagulants.
8.
Smoking can increase the metabolism of oral contraceptives, reducing their effectiveness.
9.
Long-term consumption of tea or certain herbs may have additive or subtractive effects with oral contraceptives.
Additionally, any medication should be taken with water and not with tea, coffee, or other beverages, as this may affect the medication's efficacy.
If you need to take any of the mentioned medications while on oral contraceptives, you may continue to do so, but it is advisable to use additional contraceptive measures for seven days.
Thank you! Wishing you safety and health, Dr.
Zhang.

Reply Date: 2023/03/26

More Info

When it comes to understanding drug interactions, particularly between birth control pills and antibiotics, it's essential to consider the specific medications involved and their effects on each other. In your case, you are taking Diane-35, a combined oral contraceptive pill, and doxycycline, an antibiotic.

Historically, there has been concern that certain antibiotics could reduce the effectiveness of hormonal contraceptives. However, the majority of recent studies and guidelines indicate that most antibiotics, including doxycycline, do not significantly affect the efficacy of birth control pills. The only antibiotic that has been consistently shown to have a potential interaction with hormonal contraceptives is rifampin, which is used to treat tuberculosis. Doxycycline does not fall into this category.

Given that you are currently on Diane-35 and have started taking doxycycline for your cold, you can continue taking your birth control pill as scheduled. The contraceptive effect of Diane-35 should remain intact, and you do not need to take any additional contraceptive measures while on doxycycline. However, it is always wise to consult with your healthcare provider for personalized advice, especially if you have any concerns or if your situation changes.

As for when to start your new pack of Diane-35, you can resume taking it after the 7-day break, even while you are on doxycycline. The timing of your antibiotic treatment should not interfere with the initiation of your new birth control pack. Just ensure that you take your pills consistently and as directed.

It's also important to note that while doxycycline itself does not affect the efficacy of birth control pills, antibiotics can sometimes cause gastrointestinal side effects, such as diarrhea or vomiting, which could potentially affect the absorption of the contraceptive pill. If you experience significant gastrointestinal upset, it may be prudent to use a backup method of contraception, such as condoms, until you are sure that the birth control pill has been fully absorbed.

In summary, you can continue taking Diane-35 while on doxycycline without worrying about a decrease in contraceptive effectiveness. If you have any lingering concerns or experience any unusual symptoms, don't hesitate to reach out to your healthcare provider for further guidance. It's always better to be cautious and informed when it comes to your health and contraceptive choices.

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