Medication and the Pill: What Do You Need to Know?

Do Medicines Affect the Pill?
What about antibiotics?
What about long-term medication?
Herbal Remedies and Contraception
What Medications Affect Hana?
Emergency Contraception
Preventing Pregnancy on Medication

When taken at the same time every day, contraceptive pills, such as Hana, are more than 99% effective at preventing unplanned pregnancies.

The pill is a great way to feel empowered by your contraceptive choices: following a consultation with your doctor or pharmacist, you decide when you take it, which pill you want to use, and if you want to stop. But this also comes with responsibility; to use your pill effectively you need to understand what might change its efficacy.

“Taking your pill at the same time every day is extremely important,” says pharmacist Deborah Evans*, “but other factors can make your pill less effective. Some medications can reduce the pill’s effectiveness and this might lead to a pregnancy.”

So which types of medication affect the pill and why? Let’s take a look.

Do Medicines Affect the Pill?

You should tell your pharmacist or doctor if you are taking, have recently taken or may start taking any medications as some can affect your hormones and cause your contraceptive pill to be less effective. This includes non prescriptive medications and herbal remedies. It is always important to seek medical advice from your doctor or pharmacist if you’re on the pill and start taking a new medicine or herbal remedy.

If you start taking any new medicines, you should speak to your doctor or pharmacist about how it may impact the effectiveness of your pill. They can tell you if you can continue taking your pill and if you should use an additional method of contraception, like a condom, as well.

What about antibiotics?

You may well be familiar with antibiotics – the drugs that help us fight off infections. Lots of people know that you shouldn’t drink alcohol while using some antibiotics, but did you know that you should also be careful when having sex while using some antibiotics?

If your doctor is prescribing you a new medication, it is important to tell them that you are taking Hana. They can tell you if it is OK to take at the same time, and whether you need to use additional contraception.

Some antibiotics, such as rifampicin and rifabutin, may interfere with how your contraceptive pill works and reduce how effective it is.

What about long-term medication?

Some women and people with uteruses have to take more long-term medications to manage underlying health conditions. If so, it’s important to tell the pharmacist what you’re taking and check with them whether or not these will interfere with either your pill or the new medicine you’re taking.

Enzyme-inducing drugs, in particular, can make your pill less effective. “Enzyme-inducing medications,” Deborah explains, “break down the hormones in your body. Because of this they can interfere with hormonal contraception and make the pills less effective.”

Enzyme-inducing medications include treatments for:

● Epilepsy
● Tuberculosis
● Pulmonary arterial hypertension
● Depression
● Fungal infections (such as griseofulvin)

While you are taking and once you have stopped taking an enzyme-inducing drug, you will need to use an additional method of contraception alongside the pill for at least 28 days.

Herbal Remedies and Contraception

Taking herbal remedies can have one, very inconvenient, unintended side effect if they stop your pill from working. Before you start taking them, make sure your herbal remedies won’t interfere with your birth control.

St John’s Wort is a herbal remedy that some people choose to use to treat low mood and mild anxiety, however it can impact the effectiveness of Hana and other contraceptive pills. It is important you tell the pharmacist if you are taking any herbal remedies, including St John’s Wort.

What Medications Affect Hana?

Because Hana is a desogestrel progestogen-only pill (or PoP) it works by altering the hormone levels in your body so that ovulation does not take place. This means it can be affected by medications for:

● HIV infections (e.g. efavirenz)
● Hepatitis C viral infections (e.g. boceprevir, telaprevir)
● Bacterial infections (e.g. Clarithromycin, erythromycin)
● Epilepsy (e.g. primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine,felbamate, topiramate, phenobarbital)
● Tuberculosis (e.g. rifampicin, rifabutin)
● Pulmonary arterial hypertension: high blood pressure in the blood vessels of the lungs (bosentan)
● Depression (the herbal remedy St. John’s Wort)
● Fungal infections (such as griseofulvin, itraconazole, fluconazole)
● Antibiotics (such as rifampicin and rifabutin)
● High blood pressure, angina or certain abnormal heart rhythm (e.g diltiazem)

Some of these treatments reduce the effectiveness of Hana. If you are using any of these medicines or herbal remedies for short-term treatment, you can continue taking Hana, but you must also use extra contraception (for example, condoms) every time you have sex during treatment and until 28 days after stopping the last dose of the other medicine or herbal remedy.

Please consult your doctor for advice if you are taking one or more of these medicines for chronic or long-term treatment. For more information about Hana and possible interactions with
other medications, please read the package leaflet (you can view it online here).

Emergency Contraception

If you use an emergency contraceptive pill containing ulipristal acetate, you should not take Hana for 5 days afterwards as this can impact the effectiveness of both medicines – you should use an additional method of contraception if you have sex during this time. When you resume taking Hana, you will then need to use a condom for a further 7 days as your pill will not be effective.

Preventing Pregnancy on Medication

If you are taking any of the drugs mentioned in this article then this could mean your oral contraceptive pill is less effective. In that case, you should use an alternative method of contraception such as condoms.

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When it comes to medication and the pill: knowledge is power. The more you understand about drug interactions with your pill, the better. You can find loads of information about Hana in your package leaflet (which comes in the box your pill is in, or you can read it online here). If there’s anything you’re unsure about, talk to your doctor or pharmacist who will be able to help you.

“As pharmacists, our job is to provide you with all the information you need to make an empowered decision,” says Deborah. “So don’t be afraid to ask us questions about your medication.”

*Deborah Evans does not endorse any pharmaceutical brands or products.