Oct 30, 2017 I was prescribed antibiotics which are known to make hormonal birth control pills less effective. I am supposed to use a backup method for 7 days after completing the antibiotics. When I finish my antibiotics I will have 3 days left of bcp and then 7 placebo pills. Do I need to wait 7 days into my next pack? Or is 3 hormonal and 4 placebo OK? The jury is still out on just how much most antibiotics affect birth control. Studies have shown that most antibiotics do not significantly reduce the concentrations of oral contraceptives in the body and the efficacy of birth control pills is unchanged. The only antibiotics that have a definitive and well documented negative effect on oral contraceptive levels, based on the data we have, are ones from the rifamycin family of antibiotics such as rifampin. On the other hard, there are studies that note that there are a small number of individual patients who do in fact experience a significant decrease in concentrations of oral contraceptives when taking antibiotics and appear to ovulate (which birth control pills are supposed to suppress). The problem is that it is difficult to identify exactly who is susceptible. In addition, antibiotics are known to cause changes to our normal bacterial gut flora. This could theoretically affect how estrogen and progestin from birth control pills are metabolized since our gut bacteria are involved in how our bodies process these hormones. This change in gut flora could potentially decrease the concentrations of the hormones in oral contraceptives, ultimately leading to spotting and a loss of contraceptive efficacy. Overall, the general consensus appears to be that most antibiotics do not pose a problem in those on birth control BUT women who may be affected are not easily identified and the true number of incidences of pregnancy while on antibiotics may be under-reported in total. Since unplanned pregnancy has major consequences, it may be prudent to use an additional method of contraception during short-term antibiotic use, just to be safe. In terms of how long to use a backup method, it is most often recommended to use the backup method for 7 consecutive days of ACTIVE pills. This is the usual recommendation in patients that could potentially experience changes in how their bodies absorb and metabolize their birth control pills. Digestion issues, vomiting, diarrhea, and antibiotic use are all common reasons this could happen. In your situation, make sure you use back up contraception for 7 active pills in row, from your new pack. Be sure to speak with your doctor regarding your concerns as well. Top things to know
I’m on hormonal birth control. Can I get pregnant if I take antibiotics?In most cases, no, as long as you continue to use your hormonal contraception as prescribed you are safe from pregnancy even if you are on antibiotics.
There is however, one class of antibiotics that is the exception: rifamycins (1). What do I need to know about Rifamycins?Rifamycins are a class of antibiotics. The most commonly prescribed rifamycin is known by the name rifampin. (Other types of rifamycins include rifapentine, rifabutin, and rifaximin.) Rifampin is not prescribed very commonly in the United States.
Rifampin can sometimes be used in combination with other antibiotics to treat other bacterial infections too (1). (Fun fact about rifampin: one of the side effects is that it may turn your urine, tears, saliva, and sweat a red color (3).) Rifampin, can speed up the liver’s ability to break down molecules and medications, including hormonal birth controls, which are processed continually through the liver (3). For this reason, anyone taking any form of hormonal contraceptive, like the pill, patch, ring, mini-pill, and the implant, who is prescribed rifampin treatment should note that their hormonal contraceptive will not be as effective, and may increase their likelihood of becoming pregnant (3-5). Rifampin does not interact with other forms of birth control, such as the contraceptive shot, the copper IUD, and the hormonal IUD, meaning that you can continue to use these types of contraception while undergoing rifampin treatment (4,5). What if my healthcare provider prescribes rifampin for me?If your healthcare provider does prescribe rifampin to you, be sure to let them know if you are using a hormonal contraceptive. Unless otherwise stated by your healthcare provider, you can still continue to take your pills as usual every day. However, during this time, it’s important to use non-hormonal birth control methods, like external or internal condoms, or abstain from sex as backup protection during rifampin treatment (3). If you use birth control pills, consider following the recommendations for what to do if you miss two or more pills:
If you are using another form of hormonal contraceptive, like the patch or ring, speak to your healthcare provider. Things to keep in mind, when you’re sickEven if you aren’t on rifampin, being ill is hard on the body and mind. If you are sick, it’s easy to lose track of time and responsibilities, and you might forget to take your pill (or other daily medication). Use Clue to set up pill reminders, or task a family member, partner, or friend, to help remind to make sure to take your contraceptive pill daily at the same time. Use the Clue app to set up daily pill reminders. |
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