Antibiotic Effects on Oral Contraceptives

Today’s pearl addresses a misconception regarding a drug interaction between oral contraceptives and antibiotics.

Are back-up methods of contraception required? Does this apply to all antibiotics?

Question: Is there a drug interaction between antibiotics and hormonal contraception that reduces the effectiveness of the contraceptive?

Answer: No, with one exception. In a 2018 systematic review, there was no evidence of a drug interaction in both clinical and pharmacokinetic studies (Simmons 2018). The exception is rifamycin antibiotics such as rifampin, which was addressed in a separate systematic review from the same author group (Simmons 2018).

Take-Home Point: “Most women can expect no reduction in hormonal contraceptive effect with the concurrent use of non-rifamycin antibiotics.”




Author: Bryan D. Hayes, PharmD

Attending Pharmacist, Emergency Medicine and Toxicology, Massachusetts General Hospital; Assistant Professor of EM, Harvard Medical School

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