What medications interfere with birth control pills?

Medically reviewed by Sally Chao, MD. Last updated on Feb 24, 2025.

Official Answer by Drugs.com

The list of medications below can interfere with birth control pills by making them less effective. These medications pass through the same enzyme systems in the body that break down birth control pills.

Antibiotics

Rifadin (rifampin) – treats tuberculosis infection
Mycobutin (rifabutin) – treats mycobacterium avium complex (MAC) in HIV infection

Antifungals

Gris-PEG (griseofulvin) – treats certain types of fungal infections

Anti-HIV medications

Prezista (darunavir)
Sustiva (efavirenz)
Kaletra (lopinavir/ritonavir)
Viramune (nevirapine)
Tybost (cobicistat)

Anti-seizure medications

Carbatrol, Epitol, Equetro, Tegretol, Terel (carbamazepine)
Felbatol (felbamate)
Trileptal, Oxtellar XR (oxcarbazepine)
Phenobarbital
Dilantin, Phenytek (phenytoin)
Mysoline (primidone)
Topamax (topiramate)

Other prescription medications

Provigil (modafinil) and Nuvigil (armodafinil) – improve wakefulness in certain situations, such as narcolepsy, shift-work sleep disorder and obstructive sleep apnea
Bridion (sugammadex) – reverses anesthesia after surgery
Emend (aprepitant) – treats nausea and vomiting associated with chemotherapy
Tracleer (bosentan) – treats pulmonary arterial hypertension

Herbal treatments

St. John's wort may aid in depression. However, in several small studies, it has been associated with markers of lowered hormone concentrations when taken with oral contraception.

Herbal supplements are not regulated the same as other medicines, and therefore their interactions with other drugs may not be well understood or studied in humans. It’s important to let your health care provider know of any herbal supplements and over-the-counter medicines you take.

Preventing unintended pregnancy

If you are taking these medications short-term, using a barrier method of birth control such as a condom is recommended. If you need to take any of these medications long-term, ask your health care provider about switching to a non-hormonal type of birth control, such as a copper IUD.

Related questions

References

Aronson JK, Ferner RE. Analysis of reports of unintended pregnancies associated with the combined use of non-enzyme-inducing antibiotics and hormonal contraceptives. BMJ Evidence-Based Medicine. 2020. http://dx.doi.org/10.1136/bmjebm-2020-111363.
Simmons KB, Haddad LB, Nanda K, et al. Drug interactions between rifamycin antibiotics and hormonal contraception: a systematic review. BJOG. 2018;125(7):804-811. https://doi.org/10.1016/j.ajog.2017.07.003.
U.S. Food and Drug Administration (FDA). Rifadin (rifampin capsules USP) and Rifadin IV (rifampin for injection USP). January 2022. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/050420s087,050627s030lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Mycobutin (rifabutin capsules USP). September 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/050689s026lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Gris-Peg (griseofulvin Ultramicrosize) Tablets, USP 125 MG; 250 MG. April 2016. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050475s057lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Prezista (darunavir) oral suspension Prezista (darunavir) tablet, for oral use. August 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021976Orig1s063lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Sustiva (efavirenz) capsules for oral use Sustiva (efavirenz) tablets for oral use. October 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020972s057,021360s045lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Kaletra (lopinavir/ritonavir) capsules (lopinavir/ritonavir) oral solution. October 2020. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021251s059,021906s054lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Viramune (nevirapine) tablets, for oral use Viramune (nevirapine) oral suspension, for oral use. September 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020636s050,020933s040lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Tybost (cobicistat) tablets, for oral use. September 2014. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/203094s000lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Tegretol carbamazepine USP Chewable Tablets of 100 mg - red-speckled, pink Tablets of 200 mg – pink Suspension of 100 mg/5 mL Tegretol -XR (carbamazepine extended-release tablets) 100 mg, 200 mg, 400 mg. March 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/016608s115_018281_s058_018927s055_020234_s047.pdf. [Accessed February 8, 2022].
U.S. National Library of Medicine MedlinePlus. Phenobarbital. February 7, 2022. Available at: https://medlineplus.gov/druginfo/meds/a682007.html. [Accessed February 9, 2022].
American Family Physician. Effect of Antiepileptic Drugs on Oral Contraceptives. 2008. Available at: https://www.aafp.org/afp/2008/0901/p634.html#:~:text=Antiepileptic%20drugs%20known%20to%20induce,increased%20risk%20of%20unplanned%20pregnancy. [Accessed February 8, 2022].
Reddy DS. Clinical pharmacokinetic interactions between antiepileptic drugs and hormonal contraceptives. Expert Rev Clin Pharmacol. 2010;3(2):183-192. https://doi.org/10.1586/ecp.10.3.
U.S. Food and Drug Administration (FDA). Provigil (modafinil) tablets, for oral use, C-IV. January 2015. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020717s037s038lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Nuvigil (armodafinil) tablets, for oral use, C-IV. February 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021875s023lbl.pdf. [Accessed February 8, 2022].
Berry-Bibee EN, Myong-Jin K, Tepper NK, Riley HEM, Curtis KM. Co-administration of St. John's wort and hormonal contraceptives: a systematic review. Contraception. July 18, 2016. https://doi.org/10.1016/j.contraception.2016.07.010.
National Center for Complementary and Integrative Health (NCCIH). Saw Palmetto. February 8, 2022. Available at: https://www.nccih.nih.gov/health/saw-palmetto#:~:text=Currently%2C%20saw%20palmetto%20is%20promoted,hair%20loss%2C%20and%20other%20conditions. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Bridion (sugammadex) Injection, for intravenous use. June 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022225s008lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Emend (aprepitant) capsules, for oral use. November 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021549s030,207865s003lbl.pdf. [Accessed February 8, 2022].
U.S. Food and Drug Administration (FDA). Tracleer (bosentan) tablets, for oral use. May 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021290s039,209279s005lbl.pdf. [Accessed February 8, 2022].

What should I expect after a Mirena IUD removal?

It is typically less painful to get your Mirena IUD removed than it is to get it inserted but for a few hours or days after the removal you may experience some light pain and bleeding, cramping, or feel dizzy. An IUD removal typically takes about 5 minutes, but you should allow 20 minutes for the whole appointment. Consider eating something before your appointment so you are less likely to feel dizzy, and take some painkillers, such as acetaminophen or ibuprofen one hour before to help with any pain. Most women can go straight back to work or study or usual activities after the IUD is taken out. Continue reading

What are the signs that Plan B didn't work?

If you have had to take Plan B as an emergency contraceptive, you may be wondering if it has worked. While research shows it has an efficacy rate of 89% when used correctly, how easy is it to tell if it has worked for you? The easiest way to know that it hasn’t worked are a missed period and a positive pregnancy test. Continue reading

Can you have sex after taking Plan B?

While you can have sex after taking Plan B One-Step, it is important to use a back-up method to prevent pregnancy from occurring. Plan B One-Step is only meant to be taken one time after having unprotected sex. Having unprotected sex after taking Plan B One-Step could mean sperm might outlast the effects of the medication. Continue reading

What medications interfere with birth control pills?

Related questions

Read next

What should I expect after a Mirena IUD removal?

What are the signs that Plan B didn't work?

Can you have sex after taking Plan B?

See also:

Imuran

Rituxan

Tepezza

Cytoxan

Truxima

Ruxience

Azasan

Riabni

Carvykti

Abecma

Talvey

Decadron

Dexamethasone Intensol

Revlimid

Darzalex

Velcade

Pomalyst

Kyprolis

Related medical questions

Related support groups