Birth control and your medications

A young woman looks at her pack of birth control pills while lying on the couch at home.

Which medications can interact with birth control and make it less effective?

Birth control pills and other types of hormonal contraceptives are 99% effective in preventing pregnancy, if used correctly.1 But there are certain medications and herbal supplements that can make your birth control less effective. If you’re taking birth control to prevent pregnancy, it’s important to be aware of these.

What are hormonal contraceptives?

While condoms, sponges, diaphragms, and copper intrauterine devices (IUDs) don’t release hormones, many types of birth control do. These birth control methods work by releasing hormones that:

  • Make ovulation less likely.
  • Make it harder for sperm to pass through the cervix and fertilize an egg.
  • Make it harder for a fertilized egg to implant in the uterus.

Hormonal birth control methods include:

  • Birth control pills, including the “mini-pill”
  • Vaginal rings
  • Most IUDs
  • Depo-Provera® injection
  • Nexplanon® implant
  • Birth control patches

What medications make hormonal birth control less effective?

Just as other medications, vitamins, and supplements you take can interact with each other, they can also keep your birth control from working as it should.

A recent survey sponsored by Express Scripts® Pharmacy found that 85% of women believe antibiotics affect birth control,2 but most antibiotics actually don’t.

Here are some examples of the types of medications that could affect your hormonal birth control. Check with your pharmacist if you have any questions about a specific medication.

  • Antibiotics used in the treatment of tuberculosis
  • Anticonvulsants used to prevent seizures, help with nerve pain, and treat migraines and insomnia
  • Antiretrovirals used to manage HIV
  • Medications used to help lower cholesterol
  • Diabetes medication used to control blood sugar levels
  • Herbal supplements such as St. John’s wort, melatonin, and garlic pills

If you’re taking one of the types of medications listed above, it’s important to use a back-up method of birth control to prevent pregnancy.

Talk to your doctor and pharmacist

Make sure each of your doctors and your pharmacist are aware of all the prescription medications you take and any over-the-counter medications, vitamins, and herbal supplements, too. They can help you find the best medications to treat your health without any interactions.

If your health benefits include Express Scripts® Pharmacy and you have questions about your birth control or about possible interactions, give us a call. We have pharmacists specially trained in women’s health conditions and medications who are available 24/7.

1 Cleveland Clinic: Birth Control Pills (accessed October 26, 2023):
2 June 2023 Suzy research among 15,380 consumers.

Posted date: January 12, 2024

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