Birth Control & Medication Interactions: 10 Meds to Know About

For anyone taking birth control, you want to be able to trust that it is as effective as possible. However, some medications may decrease the effectiveness of your birth control due to certain drug interactions that can occur. 

When taking birth control with one or more additional medications, discussing the potential interactions and complications that may occur with your healthcare practitioner is crucial. While most medications are safe to take alongside birth control, some, such as anticonvulsants and certain antibiotics, can produce unwanted or risky results. 

This article discusses the potential drug interactions between birth control and other medications, including the top 10 medications to know about when taking birth control. 

Keep reading to learn how to safely use birth control while taking other medications.  

What to know about taking other medications while on birth control 

Whenever you are on a birth control prescription, it is essential to be aware of possible interactions between birth control and other drugs.  

An interaction occurs when a person takes more than one medication and affects the other.

Regarding birth control, interactions are important to know about because certain medications may diminish the effectiveness of birth control, heightening pregnancy risk.  

In general, a healthcare practitioner will not prescribe you medications that interfere with the effectiveness of your birth control unless necessary. 

However, there are instances when taking a medication that interacts negatively with birth control may be a necessity. In these instances, it is crucial to talk with your healthcare practitioner about what interactions may occur and how they can be properly managed. 

Ten medications that interfere with birth control  

1. Antibiotics 

One of the most commonly known medications that potentially interact with birth control is antibiotics — but how much can antibiotics affect birth control? 

It is commonly thought that all antibiotics decrease the effectiveness of birth control, but this is not the case. Most antibiotics are safe to take with birth control and do not cause significant complications due to drug interactions. 

However, one antibiotic, called rifampin, does lessen the effectiveness of birth control.  

Rifampin — known more commonly under the brand names Rofact or Rifadin — is an antibiotic used to treat tuberculosis and other infections.  

Research from the Canadian Journal of Infectious Diseases on the interactions between antibiotics and oral contraceptives found that the main problem with rifampin arises from the antibiotic causing reductions in plasma concentrations of estrogen. For birth control to be most effective, estrogen levels must remain as steady as possible — thus, this effect from rifampin can diminish its effectiveness.  

Regarding other antibiotics, most are either amoxicillin or other penicillin-like medications. Luckily, these antibiotics are not considered to affect the effectiveness of birth control. 

Talk to a healthcare practitioner if you have concerns about potential interactions or side effects.

2. Antidepressants 

If you are on antidepressants and want to begin birth control — or vice versa — then good news: there are no known interactions between antidepressants and birth control. 

Many people take a mix of both birth control and antidepressants, as these medications are safe to be taken together.  

Of course, you should always discuss your current medication regimen with your healthcare practitioner before starting any new medications. 

3. Anti-anxiety medication 

Like antidepressants, anti-anxiety medications — such as SSRIs — do not have any known interactions with birth control medications. 

An essential consideration for anti-anxiety and antidepressants is that these medications can have starting side effects, such as mood swings or headaches. This is important to note as birth control medications are also known to have side effects during the first one to two months of use and can also include mood swings or headaches. 

If you start these medications simultaneously, you may experience more side effects than you would have by creating them one at a time.  

Thus, discuss with your healthcare practitioner how to properly start taking these medications and what side effects you can expect in the beginning. Sometimes, your practitioner may recommend starting one and then waiting a few weeks or months before starting the other. 

Always contact your healthcare practitioner immediately if starting side effects worsen in severity or do not subside after one to two months of consistent use.  

4. Anti-HIV medication 

Anti-HIV medications are a type of antiretroviral medication that helps to treat or prevent HIV (human immunodeficiency virus). 

Most antiretroviral medications have limited interactions with oral birth control medications that do not affect the contraceptive’s effectiveness.  

One antiretroviral called efavirenz, however, does have an interaction with oral contraceptives. 

Research shows that efavirenz may compromise the effectiveness of combined birth control pills and may have interactions with contraceptive implants as well (though the efficacy of implants is thought to remain intact despite these interactions).  

Antiretrovirals can be essential medications for the treatment or prevention of HIV. Thus, you should never stop taking the antiretroviral medication without the guidance of a healthcare practitioner.  

Toronto General Hospital offers a comprehensive list of all known interactions between antiretrovirals and hormonal contraceptives that can be helpful to review.  

5. Anti-convulsant medication 

Anticonvulsant medications — also called antiepileptic medications — are used to treat and prevent seizures in people with epilepsy.  

There are known interactions between anticonvulsants and hormonal contraception that can make taking the two medications together complicated. Both drugs can lessen each other’s effectiveness, depending on which anticonvulsant is paired with which hormonal birth control method.  

The solution is to switch either the anticonvulsant or the hormonal contraceptive that a person is prescribed. 

Research shows that the anticonvulsants that are less likely to disrupt the effectiveness of birth control include: 

• Brivaracetam 
• Clobazam 
• Ethosuximide  
• Gabapentin 
• Lacosamide 
• Levetiracetam 
• Lamotrigine 
• Pregabalin 
• Vigabatrin 
• Stiripentol 

As for hormonal contraception, the birth control methods that are considered safer to take with anticonvulsants include: 

• Hormonal or non-hormonal intrauterine devices (hormonal IUDs contain levonorgestrel, while the non-hormonal IUD is called a copper intrauterine device)  
• Medroxyprogesterone depot injections  
• Continuous cycle estrogen-progestin birth control pills (must contain at least 30μg of estrogen and be taken every day of the month with a four-day break every three months) 

Since the potential for interactions between anticonvulsants and hormonal contraception is high, always consult a healthcare practitioner before combining these medications.  

6. Anti-nausea medication 

One anti-nausea medication that may decrease the effectiveness of birth control is called aprepitant (and its bioequivalent fosaprepitant).  

Specifically, aprepitant is shown to interact the most with birth control that contains ethinylestradiol (estrogen). Anyone experiencing excessive vomiting and being prescribed aprepitant as a treatment should be aware of its potential to decrease the effectiveness of estrogen-containing birth control. 

Likewise, if you are experiencing excessive vomiting and take birth control pills, your birth control medication may have left your system before it could fully absorb. As a result, you should consider it a missed dose for the day.  

7. Antifungal medication 

Antifungal medications (also called antimicrobials) are used to stop and kill the growth of fungi that can cause infections on and in the body. 

Research shows a very low risk of interactions between antifungal medications and oral contraceptives. However, the risk is still present, so it is important to discuss the potential for your birth control to have lowered effectiveness when taking antifungal medication with your healthcare practitioner.  

8. Diabetes medication  

Although birth control is thought to have a limited effect on a person’s blood sugar levels, this impact is generally not considered enough to alter diabetes medication doses.  

The key to managing the effects of hormonal contraceptives on glycemic regulation is to regularly check your blood sugar levels, especially when taking birth control. Additionally, you should speak with your healthcare practitioner about all of your diabetes risk factors and potentially consider taking a low-dose hormonal or non-hormonal birth control alternative instead.  

9. General anesthesia 

As general anesthesia continues to become more medically advanced, new drugs are being introduced to the medical process — including some that may affect your birth control’s effectiveness.  

Sugammadex is a selective relaxant binding agent used primarily to reverse the effects of muscle relaxants induced during general anesthesia. Studies have shown that sugammadex can potentially bind estrogen and progestin found in oral contraceptives together, causing decreased effectiveness. 

As a result, it is recommended for anyone on hormonal contraception to use emergency contraception, a backup method of contraception, or practice abstinence for the first seven days after exposure to sugammadex.  

10. Herbal remedies  

Many different herbal remedies and supplements can interact with hormonal birth control and have the potential to decrease the effectiveness of  

These include: 

• Licorice 
• Alfalfa 
• Marijuana  
• Black Cohosh 
• Saint John’s Wort  
• Ginseng 
• Kava-Kava 
• Saw Palmetto 
• Sene 
• Soybeans 

Given the potential for interactions between herbal remedies and hormonal birth control, disclosing any herbal remedies or supplements, you take to your healthcare practitioner is always important. 

Additionally, it is essential to note that the medical community is still working on expanding healthcare practitioners’ awareness of potential interactions between herbal medications and birth control. Thus, it is best to proceed cautiously and do extensive research before pairing any herbal remedy with a birth control prescription.  

What to do if you need to take a medication that interferes with birth control  

Most medications that interfere with birth control are still safe to take — you just need to be aware that your risk of pregnancy may be higher when taking these medications.  

The most crucial step to take is to discuss all medications (including vitamins, herbal remedies, and supplements) that you are taking with your healthcare practitioner.  

Do I need to disclose my birth control status to healthcare practitioners?  

While you are not legally required to disclose your birth control status to healthcare practitioners, it is crucial to do so.  

Birth control is generally considered safe, but certain risk factors, such as high blood pressure, can make it a riskier medication for some people. Additionally, if you are on other medications or are prescribed new ones, disclosing your birth control status to healthcare practitioners will ensure you know all the potential interactions your medications may have.  

Key takeaways 

The key to a trustworthy birth control prescription is a reliable healthcare practitioner who will have open and honest discussions about all the risk factors, potential drug interactions, and side effects associated with birth control. 

Get started with Felix today to discuss your birth control options with a reputable healthcare practitioner.