the Impact of Citrus on Emergency Contraceptive Pills

Regarding the use of emergency contraceptive pills?

I would like to ask the doctor: 1.
I have seen many people say that taking pre-exposure prophylaxis (PrEP) should not be combined with citrus fruits and foods.
Last night, I had dinner with friends and drank beverages containing citrus fruits, and I did not wait four hours before taking the medication.
Will this affect the effectiveness of the contraception? 2.
If it does have an impact, what should I do? Should I finish the remaining pills? Will taking them all still provide contraceptive protection? 3.
Besides citrus fruits and grapefruit, are there any other foods that should be avoided while taking PrEP? Can I consume lychee, coffee, tea, supplements, and fish oil? Lastly, thank you, doctor, for your patient answers!

Nai Mei, 30~39 year old female. Ask Date: 2023/07/29

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it generally does not have an impact.
Wishing you good health.

Reply Date: 2023/07/29

More Info

When it comes to the interaction between citrus fruits and emergency contraceptive pills (ECPs), there are several important factors to consider. Let's break down your questions one by one.

1. Citrus Fruits and Emergency Contraceptive Pills: The concern about citrus fruits, particularly grapefruit, stems from their ability to affect the metabolism of certain medications. Grapefruit and some other citrus fruits can inhibit the cytochrome P450 3A4 enzyme in the liver, which is responsible for metabolizing many drugs, including some hormonal contraceptives. However, most emergency contraceptive pills, such as those containing levonorgestrel or ulipristal acetate, are not significantly affected by citrus consumption. Therefore, consuming citrus fruits or drinks shortly before or after taking ECPs is unlikely to impact their effectiveness.
2. If There Is an Impact: Given that the interaction is minimal for most ECPs, if you have consumed citrus and then taken your emergency contraceptive, there is generally no need for concern. You should continue to take the remaining pills as prescribed. Completing the course of medication is important for ensuring maximum effectiveness. If you have any doubts or experience unusual symptoms, it is always best to consult with a healthcare provider for personalized advice.

3. Other Foods and Supplements: Besides citrus fruits, there are no widely recognized food interactions that would significantly affect the efficacy of emergency contraceptive pills. However, it is advisable to be cautious with certain supplements and herbal products. For instance, St. John's Wort is known to induce the metabolism of various medications and could potentially reduce the effectiveness of hormonal contraceptives. As for foods like lychee, coffee, tea, and fish oil, they do not have documented interactions with ECPs, so they can generally be consumed without concern.

In summary, while there are some medications that can interact with citrus fruits, emergency contraceptive pills are not significantly impacted by them. It is always prudent to follow the instructions provided with your medication and consult with a healthcare professional if you have specific concerns. Maintaining open communication with your healthcare provider can help ensure that you are using contraceptives effectively and safely.

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