Antibiotics and the pill

[Angeldelight123]

Hi there, I am on the pill Rigevidon. During my previous cycle, I had to take the antibiotic Flucloxacillin during the third week of my pill cycle, I finished the course of antibiotics 2 days before my break started, I took my 7 day break and had my withdrawal bleed as usual. I was wondering, I heard antibiotics may affect contraception, and since I had to take them during my third week and then took my 7 day break 2 days after I finished them, would I still be covered during that time or did I have to wait to take the pill for 7 days after to have protection like you do with the very first packet. would I still be covered even in my 7 day break despite the antibiotics? or would I have to wait for the hormones to 'build up' again? I hope this makes sense.

[Jacob]

Hi Angel delight!

We have a piece about this which I can quote for you!

Under what may interfere with BC.

from Something You Can Worry About Less: Interference and Hormonal Birth Control...

Common antibiotics such as amoxicillin, ampicillin, ciprofloxacin, clarithromycin, doxycycline or metronidazole. Current research indicates that almost all antibiotics have no effect on the efficacy of hormonal birth control. However, much of this research has included sample sizes considered too small to detect a rare interaction that may occur in less than 1% of users. So if you are taking an antibiotic, your decision to take more precautions depends on how much risk you are or are not comfortable with. Keep in mind also that if you are taking an antibiotic, your body is probably also battling an infection, which makes you more susceptible to other infections like STIs. The bottom line: if you are someone who wants to minimize these risks as much as you can, consider using condoms as a backup, the only method that can protect you from infections and pregnancy: not just for a week or so after finishing your antibiotic regimen as doctors often suggest, but all the time, too.

Under what does interfere with hormonal BC:

The antibiotic rifampin, used to treat both latent and active tuberculosis (TB): Regimens for rifampin and similar drugs often last several months. Consult with your doctor about special considerations for sexual activity and contraception if you are being treated for TB.

[Angeldelight123]

Hi,
I did read that article, but to be honest I don't really understand it. I'd rather I got a straight answer, but the info there seems to be quite controversial, so I'm not really sure I'd rather I knew straight up if there was an interaction or not.
I read my pill leaflet, and it doesn't state the antibiotic I was taking at all under the interactions. Does that mean it doesn't affect my pill if it's not on the leaflet? I keep getting conflicting answers.

[Eddie C]

This is something that will be better answered by the doctor who prescribed the antibiotics. You can always call them and ask them by the phone without having to make an appointment. If they are not available, a pharmacist will be your second best choice.

[Jacob]

So, to say that something has no interraction, means you actually have to disprove it, which is pretty difficult. E.g. If I say I can walk through walls... you can prove that I have never walked through a wall. But you can't prove that I can't, there's always a slim chance that I can, in an unforseen way. However if I got arrested for some crime and put in a cell, the guards would be pretty rational in assuming walls should do the job of containing me. They've deemed the risk of me being a super villain with walk-through-wall abilities small enough to ignore, which is a fair assumption.

The thing with risk is that there is always a small chance. So what's stated in the article, is that it's lower than 1% maybe as low as ~0% but that can't be said for certain as it'd take more research.

That's the information we all have so you get to decide from there what's an acceptable risk for you. If you're uncomfortable I'd say backup with condoms until a time when you are no longer concerned... like the end of this cycle. That way you're avoiding the risk which is worrying you.

If you've heard about antibiotic interractions with birth control, that will have probably been rifampin, the one which is proven to have interractions. As it's not the drug you're using, that doesn't apply to you.

[Jacob]

Or what Edith said! Hurrah for doctors!

[Angeldelight123]

I have spoken to a couple of pharmacists and my local sexual health clinic, they said there is no interaction to worry about.

So does that mean I can trust that information that's on my pill leaflet? And do you mean the interaction between antibiotics and the pill has a 1% chance of affecting my pill? Or in other words, does that mean that antibiotics can affect the pill but it is a very very small risk?

[Angeldelight123]

I just want information that I can trust because I like knowing I have the pill to well protect me regardless if I'm using back ups, 2 methods are always better than one, and I'd most definitely like to know if I have the two methods working to the full effectiveness.

[Jacob]

It means there is no indication that there is any interraction, but that there is a margin for error. So it's not 1%, it's an unknown chance below 1% which may be none at all. However it sounds like speaking about likelihoods is abstract and adding to the stress for you! The pill manufacturer didn't think it was plausible enough for them to put it in their literature and protect themselves from a lawsuit, and the clinic and pharmacies don't deem it to be a significant enough risk to worry about it in their opinion.

The bottom line here is that there is a small unknown element. It's up to you what you do with the knowledge that it's unknown. It doesn't sound like you'll get much more information-wise, what you do next is going to have to be based on what you're comfortable with, with the information you have, and the advice given.

There isn't much further to go with this I'm afraid!

It does, however, sound like you're struggling with the stress of accepting risk, and trusting your BC... would you like any support with the emotional rather than the factual side of this?

EDIT: I read from your other thread that you've been doing therapy for anxiety, that's great! Maybe this worry could be something to bring up at therapy?