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What medications interfere with birth control pills?

Medically reviewed by Sally Chao, MD. Last updated on Feb 26, 2024.

Official answer

by Drugs.com

The list of medications below can interfere with birth control pills by making them less effective. These medications pass through the same enzyme systems in the body that break down birth control pills.

Antibiotics

  • Rifadin (rifampin) – treats tuberculosis infection
  • Mycobutin (rifabutin) – treats mycobacterium avium complex (MAC) in HIV infection

Antifungals

  • Gris-PEG (griseofulvin) – treats certain types of fungal infections

Anti-HIV medications

Anti-seizure medications

Other prescription medications

  • Provigil (modafinil) and Nuvigil (armodafinil) – improve wakefulness in certain situations, such as narcolepsy, shift-work sleep disorder and obstructive sleep apnea
  • Bridion (sugammadex) – reverses anesthesia after surgery
  • Emend (aprepitant) – treats nausea and vomiting associated with chemotherapy
  • Tracleer (bosentan) – treats pulmonary arterial hypertension

Herbal treatments

St. John's wort may aid in depression. However, in several small studies, it has been associated with markers of lowered hormone concentrations when taken with oral contraception.

Herbal supplements are not regulated the same as other medicines, and therefore their interactions with other drugs may not be well understood or studied in humans. It’s important to let your health care provider know of any herbal supplements and over-the-counter medicines you take.

Preventing unintended pregnancy

If you are taking these medications short-term, using a barrier method of birth control such as a condom is recommended. If you need to take any of these medications long-term, ask your health care provider about switching to a non-hormonal type of birth control, such as a copper IUD.

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References
  1. Aronson JK, Ferner RE. Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme-inducing antibiotics and hormonal contraceptives. BMJ Evidence-Based Medicine. 2020. http://dx.doi.org/10.1136/bmjebm-2020-111363.
  2. Simmons KB, Haddad LB, Nanda K, et al. Drug interactions between rifamycin antibiotics and hormonal contraception: a systematic review. BJOG. 2018;125(7):804-811. https://doi.org/10.1016/j.ajog.2017.07.003.
  3. U.S. Food and Drug Administration (FDA). Rifadin (rifampin capsules USP) and Rifadin IV (rifampin for injection USP). January 2022. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/050420s087,050627s030lbl.pdf. [Accessed February 8, 2022].
  4. U.S. Food and Drug Administration (FDA). Mycobutin (rifabutin capsules USP). September 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/050689s026lbl.pdf. [Accessed February 8, 2022].
  5. U.S. Food and Drug Administration (FDA). Gris-Peg (griseofulvin Ultramicrosize) Tablets, USP 125 MG; 250 MG. April 2016. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050475s057lbl.pdf. [Accessed February 8, 2022].
  6. U.S. Food and Drug Administration (FDA). Prezista (darunavir) oral suspension Prezista (darunavir) tablet, for oral use. August 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021976Orig1s063lbl.pdf. [Accessed February 8, 2022].
  7. U.S. Food and Drug Administration (FDA). Sustiva (efavirenz) capsules for oral use Sustiva (efavirenz) tablets for oral use. October 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020972s057,021360s045lbl.pdf. [Accessed February 8, 2022].
  8. U.S. Food and Drug Administration (FDA). Kaletra (lopinavir/ritonavir) capsules (lopinavir/ritonavir) oral solution. October 2020. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021251s059,021906s054lbl.pdf. [Accessed February 8, 2022].
  9. U.S. Food and Drug Administration (FDA). Viramune (nevirapine) tablets, for oral use Viramune (nevirapine) oral suspension, for oral use. September 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020636s050,020933s040lbl.pdf. [Accessed February 8, 2022].
  10. U.S. Food and Drug Administration (FDA). Tybost (cobicistat) tablets, for oral use. September 2014. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/203094s000lbl.pdf. [Accessed February 8, 2022].
  11. U.S. Food and Drug Administration (FDA). Tegretol carbamazepine USP Chewable Tablets of 100 mg - red-speckled, pink Tablets of 200 mg – pink Suspension of 100 mg/5 mL Tegretol -XR (carbamazepine extended-release tablets) 100 mg, 200 mg, 400 mg. March 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/016608s115_018281_s058_018927s055_020234_s047.pdf. [Accessed February 8, 2022].
  12. U.S. National Library of Medicine MedlinePlus. Phenobarbital. February 7, 2022. Available at: https://medlineplus.gov/druginfo/meds/a682007.html. [Accessed February 9, 2022].
  13. American Family Physician. Effect of Antiepileptic Drugs on Oral Contraceptives. 2008. Available at: https://www.aafp.org/afp/2008/0901/p634.html#:~:text=Antiepileptic%20drugs%20known%20to%20induce,increased%20risk%20of%20unplanned%20pregnancy. [Accessed February 8, 2022].
  14. Reddy DS. Clinical pharmacokinetic interactions between antiepileptic drugs and hormonal contraceptives. Expert Rev Clin Pharmacol. 2010;3(2):183-192. https://doi.org/10.1586/ecp.10.3.
  15. U.S. Food and Drug Administration (FDA). Provigil (modafinil) tablets, for oral use, C-IV. January 2015. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020717s037s038lbl.pdf. [Accessed February 8, 2022].
  16. U.S. Food and Drug Administration (FDA). Nuvigil (armodafinil) tablets, for oral use, C-IV. February 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021875s023lbl.pdf. [Accessed February 8, 2022].
  17. Berry-Bibee EN, Myong-Jin K, Tepper NK, Riley HEM, Curtis KM. Co-administration of St. John's wort and hormonal contraceptives: a systematic review. Contraception. July 18, 2016. https://doi.org/10.1016/j.contraception.2016.07.010.
  18. National Center for Complementary and Integrative Health (NCCIH). Saw Palmetto. February 8, 2022. Available at: https://www.nccih.nih.gov/health/saw-palmetto#:~:text=Currently%2C%20saw%20palmetto%20is%20promoted,hair%20loss%2C%20and%20other%20conditions. [Accessed February 8, 2022].
  19. U.S. Food and Drug Administration (FDA). Bridion (sugammadex) Injection, for intravenous use. June 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022225s008lbl.pdf. [Accessed February 8, 2022].
  20. U.S. Food and Drug Administration (FDA). Emend (aprepitant) capsules, for oral use. November 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021549s030,207865s003lbl.pdf. [Accessed February 8, 2022].
  21. U.S. Food and Drug Administration (FDA). Tracleer (bosentan) tablets, for oral use. May 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021290s039,209279s005lbl.pdf. [Accessed February 8, 2022].

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