Contraception

How safe is the pill despite other medicines?

Does the pill protect in combination with other medications?

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Readers ask, experts answer on the most pressing health issues. Katharina W. (27): "I'm taking the pill. Can there be problems if I take other medication at the same time?" 

Priv.-Doz. Dr. Karoline Mayer-Pickel University Department of Obstetrics and Gynecology, Division of Obstetrics, MedUni Graz: Yes, taking hormonal oral contraceptives ("the pill") and other medicines at the same time can sometimes lead to undesirable interactions, particularly a reduction in the contraceptive effect.

This occurs, for example, due to an increase in metabolism, which leads to an increased breakdown of the sex hormones oestrogen and progesterone (especially with antiepileptic drugs, special antibiotics) or due to a change in the bacterial environment in the intestine (due to antibiotics) with a disturbance of the enterohepatic circulation (circulation of various substances from the liver via the gallbladder to the intestine and back to the liver). This reduces the effectiveness of contraception.

However, there are now studies that show NO connection between antibiotics and oral contraceptives and a resulting loss of effectiveness. An additional contraceptive method (condom) is not necessary if antibiotics that do not affect the metabolism are taken at the same time. However, if the antibiotic or the illness leads to vomiting and diarrhea, I recommend additional contraceptive methods (including a condom).

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At the same time, the influence of hormonal contraceptives on the metabolism of other medications should not be ignored, such as the epilepsy medication lamotrigine: taking hormonal contraceptives (especially oestrogen) increases the excretion of lamotrigine via the kidneys and thus lowers the blood serum level.

This increases the risk of seizures. In a "pill-free" phase, however, the active level of the antiepileptic drug can rise sharply again - with corresponding typical drug side effects. In this case, you should switch to a condom, copper IUD, gold IUD or, if hormonal contraception is desired, to a suitable preparation with a higher oestrogen dose.