Will antibiotics stop my contraceptive pill working?

One of the more frequently asked questions about daily contraceptive pills is how taking other medication can affect them. While it would be great if we could go through life and not get ill, the vast majority of us will eventually need to take some sort of antibiotic, medication or over-the-counter medicine.

Most of the time taking these medicines will be temporary, but it’s still important to seek professional medical advice and inform the healthcare professional about any other medications you might be taking – including any contraception – so they can give you the most accurate advice.

During your life, there may be times when the medicines that you need to take will have an impact on your contraception. #AskHana is a great source of information when it comes to your contraceptive choices, but if you’re taking antibiotics it’s always important to speak to your GP or pharmacist to make sure that you have the most up-to-date information that is relevant to your current health needs.

Antibiotics are made of antimicrobial substances that kill and prevent harmful bacteria from spreading. They are often a key way of treating dangerous illnesses and stopping infections. 

The term antibiotic is broad and covers hundreds of different types of medicines, within several classifications. While some of these can interfere with your contraceptive pills effectiveness, some may not.

Two antibiotics which can prevent a pill like Hana from working properly are rifampicin and rifabutin, which are often used to treat chest related illnesses such as tuberculosis.

If you are prescribed any medication, including antibiotics, by a medical professional, it is important to tell them about your contraception so they have all the info they need.

If you take ellaOne – which contains ulipristal acetate and is the most effective* morning after pill (hormonal emergency contraceptive) while using Hana as your contraceptive pill then you should wait 5 days before starting or restarting Hana. This is because the two medicines used together can lead to temporary reduced effectiveness and increase the risk of pregnancy. 

*Verify at: ellaone.co.uk/verify

During this 5 day period, and for the first week (7 days) after starting or restarting Hana, you should use a barrier method of contraception (like condoms) if you are choosing to prevent pregnancy. This should be for a total of 12 days from taking the morning after pill. 

If you use an emergency contraception that includes the ingredient levonorgestrel, you should continue to take Hana as recommended. You should, however, use an additional barrier method  (like condoms) or not have penetrative sex for the first two days of using a progestogen-only pill if you don’t want to get pregnant, as the emergency contraception can temporarily make your pill less effective. 

For additional advice please speak to your doctor, pharmacist or local sexual health clinic.

Aside from antibiotics, there are other medicines and herbal remedies you need to be mindful of as well.

Medicines that are used for the treatment of epilepsy, HIV, pulmonary arterial hypertension, depression and fungal infections can also have an impact on Hana’s efficacy. 

You should always consult a healthcare provider to make sure that you are aware of any potential conflict. Some medicines and herbal remedies which have been known to reduce the effectiveness of the contraceptive pill are:

• Epilepsy medications (e.g primidone, phenytoin, barbiturates, felbamate, oxcarbazepine, carbamazepine, phenobarbital and topiramate)
• Medication for tuberculosis (e.g rifabutin, rifampicin)
• Some HIV medication (e.g efavirenz)
• Some medications used to treat hypertension arterial pulmonary and high blood pressure (e.g bosentan)
• Some herbal remedies used to treat depression, like St John’s Wort
• Some medications used to treat fungal infections, such as griseofulvin

All of these medicines or herbal remedies can stop Hana working properly. If you are prescribed, purchased or are recommended to use any of these for a short period, then you can continue to take Hana as recommended. However, you must also use a barrier method of contraception (like condoms) every time you have sex while taking these medications and for 28 days after you take your final dose.

If you are using any of these for a longer period of time or for a chronic condition, then consult your doctor as there may be a contraceptive that is more suited to your needs. 

Some medications can increase the level of desogestrel (the active in Hana) present in your blood, whilst others have a variable effect.

Medications which can increase desogestrel  levels in your blood include treatment for fungal infections (e.g fluconazole, itraconazole, ketoconazole), some bacterial infections (e.g erythromycin,clarithromycin), some medication used to treat high blood pressure, angina or abnormal heart rhythm (e.g diltiazem).

Medications which can have a variable effect include some used to treat HIV (nevirapine, nelfinavir, ritonavir) and Hepatitis C (telaprevir, boceprevir).

Hana can also interfere with some medications, either by increasing their effect (e.g medications containing ciclosporin) or decreasing their effect (e.g lamotrigine). 

Please read your Hana packet leaflet carefully to check for any potential interactions with other medications. Always tell your pharmacist or doctor about any other medications you are taking so they have all the info they need. 

There may be other medicines that can also interfere with how Hana works. Always speak to your pharmacist or doctor to give you clarity on additional measures that need to be taken, or any potentially side effects that may occur. 

We are fortunate to live in a time where our knowledge of health and medicine has come on in leaps and bounds. Hana is available in pharmacies or online without prescription, so inform the pharmacist about any medication you may be taking when purchasing Hana.

It’s best to have the correct guidance and information so that you can make informed choices about your health, your body and your contraception.