Do topical antibiotics affect birth control

It's a question you hear your doctor ask every time they prescribe medicine: What other drugs do you take? They are not just curious. Some meds don't work well if you take them together. The same thing is true of birth control that contains hormones. If you want it to work right, you need to avoid certain medications.

The pill -- and some other types of birth control like the patch, ring, or injections -- usually contain the female sex hormones estrogen and progestin. They stop eggs from leaving the ovaries, so you won't get pregnant. But some meds won't let the hormones do their job. If you take them at the same time as your birth control, you may not have the protection you think you do.

For the most part, you don't have to worry about taking these drugs. Doctors prescribe them to treat all kinds of infections caused by bacteria, like pneumonia, acne, and urinary tract infections (UTIs). Common antibiotics include penicillin and amoxicillin.

So far, the only antibiotic that studies show interferes with birth control is rifampin (Rifadin), a drug used to treat tuberculosis.

Rifampin causes irregular periods. It raises the risk that you may get pregnant even if you use your birth control the right way.

Apart from rifampin, you're safe to take birth control pills at the same time as antibiotics without also using a back-up method.

Some meds that treat HIV may interfere with the pill. They include:

Other HIV drugs may be OK. Talk to your doctor about what medicine is best for you.

The two main ones to watch out for are griseofulvin (Gris-PEG) and ketoconazole (Extina, Nizoral, Xolegel).

Griseofulvin is used to treat skin infections like athlete's foot and jock itch. Ketoconazole is mainly used when other anti-fungal medicines aren't available or haven't worked.

Scientists believe the risk of anti-fungal meds affecting your birth control pills is low, so check with your doctor.

Some of these medications increase the breakdown of the hormones in birth control pills. That could make them less effective. These drugs include:

Be sure to use another form of birth control (like an IUD, a diaphragm, or a condom) if you take anti-seizure medication.

Birth control medication won't interfere with how well your anti-seizure drugs work.

This is a stimulant usually used to treat the symptoms of sleep disorders like narcolepsy and sleep apnea. Studies show it lessens the effectiveness of the pill. Use another form of birth control while you're on modafinil (Provigil), and for a month after you come off it.

A number of these don't mix well with birth control pills. Some that you should avoid:

St. John's wort. Some people use it to treat mild to moderate depression and sleep disorders. A study shows that women who took birth control pills and St. John's wort at the same time had higher rates of breakthrough bleeding and an increased breakdown of estrogen in their bodies, signs that the contraceptives might not work as well as they should.

Other herbal remedies that may affect how well your birth control pills work are:

  • Saw palmetto. Some people have tried it for hair loss.
  • Alfalfa. It's used for kidney, bladder, and prostate problems.
  • Garlic pills. Some people take these for high blood pressure, high cholesterol, and other heart and blood diseases.
  • Flaxseed. This is used for digestion problems like severe constipation and irritable bowel syndrome.

SOURCES:

NAM Aidsmap: "Contraception."

Rodriguez M.D., Maria Isabel "What medications mess with birth control?" Bedsider.com

DeRossi, S.S. Dental Clinics of North America, October 2002.

McKinley Health Center, University of Illinois, "Pill Interactions With Other Drugs"

Weisberg, E. Clinical Pharmacokinetics, May 1999.

U.S. National Library of Medicine: "Griseofulvin," "Ketoconazole," "St. John's Wort," "Saw palmetto," "Garlic," "Alfalfa," "Flaxseed."
Doodipala, S. Expert Review of Clinical Pharmacology, March 1, 2010.

Epilepsy Foundation: "Women FAQ."

Robertson P. Clinical Pharmacology and Therapeutics, January 2002.

Narcolepsy UK: "All you need to know about modafinil and the pill."

Stanford Medicine: "Psychiatric Medications, Modafinil"

National Center for Complementary and Integrative Health: "Questions and Answers: A Trial of St. John's Wort (Hypericum perforatum) for the Treatment of Major Depression."

Hall, S.D. Clinical Pharmacology and Therapeutics, December 2003.

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By Amy @ Planned Parenthood | Oct. 14, 2010, 11:05 a.m.

Category: Birth Control

I was watching tv, and they said that if your on birth control and taking antibiotics the birth control will stop working. Im on the pill right now, and I’ve had to start taking antibiotics because of a kidney infection. Is it true that the birth control will stop working? and if it does how long after I stop taking the antibiotics will the birth control work again?

No. You can take the antibiotic you’ve been prescribed for your kidney infection and your birth control pill will keep protecting you. Only one antibiotic is known to make the pill less effective. That is rifampin, a special medication used to treat tuberculosis. The brand names include Rifadin and Rimactane. Other antibiotics do not make the pill less effective. There are medications that can interact with the pill and decrease its effectiveness. Also, the pill can decrease or increase the effectiveness of some medications. That’s why it’s important to be honest with your health care provider and let her or him know if you’re on the pill. Always let providers know about all the drugs and medications you take — prescription, over-the-counter, recreational — before they prescribe anything new for you.

Tags: antibiotics, birth control, the pill

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Additional Reading

  • Martin KA, Barbieri RL. Overview of the Use of Estrogen-Progestin Contraceptives.

  • Medline Plus. Estrogen and Progestin (Oral Contraceptives). U.S. National Library of Medicine.

  • Medline Plus. Bosentan. U.S. National Library of Medicine.

  • Lee CR. Drug Interactions and Hormonal Contraception. Trends in Urology, Gynaecology & Sexual Health. 2009;14(3):23-26. doi:10.1002/tre.107.