Dr. Staci Tanouye is a wellness contributor In The Know. follow her Instagram and TikTok for more.
This appears to be an unfortunate trend on TikTok: users posting videos claiming that certain supplements or foods somehow “cancel” birth control pills, also known as oral birth control pills (OCPs). By “canceling”, they mean interacting negatively with birth control pills, making them ineffective.
And in reality interact with birth control pills and what doesn’t?
This can be a very confusing question with potentially confusing answers. I’m sure that at one point, your aunt Karen told you that she lived next to a health professional who told her that the sun cancels birth control pills, which means that you would definitely get pregnant by walking outdoors without sunscreen. .
Well, probably not exactly like that, but you see where I’m going with this.
To be fair, the myth that certain things – from sunlight to antibiotics – can interact with birth control pills has been around for decades. Some of these myths are still perpetuated by healthcare professionals and pharmacists today. I can see how navigating the truths and myths surrounding the “cancellation” of birth control pills can be very confusing.
But what I’m now starting to see online are people making dangerous and unbridled claims that everything from alcohol to melatonin and cinnamon can inhibit the effectiveness of OCPs. Yes, I’m not even kidding, lower leg.
There are so many confusing messages (and crazy rumors) about what how things can interact with birth control pills.
I am here to explain to you. Here are the important things to remember:
Failure rates for OCPs with average use can be up to 9% – regardless of other medications taken at the same time.
This is not a small number when it comes to unplanned pregnancies, so it is important to realize that while we often want to blame external forces, accidents and mistakes when taking ACOs happen much more often than you think. In addition, anything that affects the absorption of any medication can decrease its effectiveness. Therefore, things like stomach swelling, various illnesses or bariatric surgery can affect the absorption of OCPs and increase failure rates.
Some medications may decrease the concentrations of ethinyl estradiol (synthetic estrogen) and / or the progesterone component in ACOs.
This is due to the fact that certain drugs do not regulate the activity of liver enzymes, which increases OCP metabolism, causing a decrease in OCP concentration. Basically, these drugs I can make birth control less effective. But the list of drugs that do this is much shorter than you think:
Phenobarbital and other barbiturates; anticonvulsants, such as phenytoin, carbamazepine, primidone, topiramate, felbamate and oxcarbazepine; the antibiotics rifampicin and rifabutin (yes, just the two – that’s all, folks); the antiseptic griseofulvin; anti-HIV medication; and St. John’s wort.
At one point, tetracyclines and penicillins were thought to decrease the effectiveness of OCPs. But this finding (based on small studies) has been contradicted by larger studies, as well as pharmacokinetic studies. But we know in science and medicine that nothing is impossible and sometimes the data evolves. If you’re still concerned, it’s always a good idea to add a condom – especially since condoms are recommended to prevent sexually transmitted infections in any way.
Even these drugs do not automatically make the effectiveness of an OCP zero.
But decreasing the concentration of an estrogen component OCPs May make them less effective in preventing ovulation. Therefore, the failure rate will not be 100% each time you take these other medications together with OCPs. But it can be higher than the 9% baseline failure rate. It also means that if a person is taking one of these medications, OCPs may still be an option for them with the appropriate informed consent, especially if they are unable to take or have access to other options. If possible, adding a barrier method, such as a condom, is a good idea. Basically, in some patients, something can be better than nothing.
Interactions between medications and OCPs can also mean other interactions besides decreasing the effectiveness of OCP.
For example, OCPs can decrease the effectiveness of lamotrigine, an anticonvulsant medication. In addition, some medications can actually increase concentrations of OCPs or vice versa. Melatonin is an example. If taken with an OCP, the concentration of OCP and melatonin can potentially increase. There is limited data here, but it is possible.
Grapefruit is another example that can increase OCP concentration. Increasing the circulating concentrations of something can increase side effects, but it should not change the effectiveness.
Wow, that was awesome. Are you still following me?
Let’s summarize things:
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The only antibiotics that have already been shown to decrease the concentration of oral contraceptives and therefore decrease effectiveness are rifampicin and rifabutin.
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Remember that OCPs have a typical baseline usage failure of up to 9% for a number of different reasons that do not include the use of antibiotics. Misplaced guilt does not help to resolve the underlying issues here.
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OCPs can also affect the concentrations of other drugs in a positive and negative way.
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Things that don’t “cancel” birth control pills: melatonin, grapefruit, caffeine, nicotine, alcohol, cinnamon and most antibiotics.
Check out this link for a reliable and up-to-date review of OCP interactions. And as always, whenever in doubt, add another backup method, if possible.
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If you found this article useful, learn what to expect before your first visit to the gynecologist.
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The post-gynecologist dispels the myths surrounding what can ‘cancel’ birth control pills that first appeared on In The Know.