progestogen only pill and antibiotics

Last edited 02/2020 and last reviewed 10/2021

The efficacy of the progestogen only pill is not, in general, affected by the use of antibiotics

• hepatic enzyme inducing antibiotics (such as rifampicin or rifabutin) do however reduce the efficacy of the progestogen only pill - rifampicin and rifabutin are such powerful enzyme-inducing drugs than an alternative method of contraception is always recommended

If using an enzyme-inducing antibiotic e.g. rifabutin, rifampicin - then will need to use additional contraceptive precautions and for four weeks after stopping the antibiotic.

Reference:

1. BNF 7.3.1
2. FSRH (2019), Clinical Guidance: Drug Interactions with Hormonal Contraception.