Posted by Sunnely on May 20, 2001, at 22:09:18
In reply to The Pill and Psychiatric Meds, posted by Ambrosia on May 20, 2001, at 15:52:45
None of the medications you are taking lessens the effectiveness of the birth control pills (as a contraceptive). However, fluoxetine (Prozac) may interfere with the metabolism of the birth control pills through inhibition of the liver enzyme CYP3A4. This action can decrease the clearance of the birth control pills from the body and prolong its estrogen-related side effects such as migraine headaches and thromboembolic events (increased risk for stroke or pulmonary embolism). Other known drugs to increase the estrogenic effects of birth control pills include the antifungals ketoconazole (Nizoral), itraconazole (Sporanox), and fluconazole (Diflucan); antivirals such as ritonavir (Norvir); certain antibiotics such as erythromycin, azithromycin (Zithromax) and clarithromycin (Biaxin); the antidepressant nefazodone (Serzone). Even grapefruit juice is known to increase estrogen levels. Estrogenic effects also increase when vitamin C or acetaminophen (Tylenol) is added. This interaction between vitamin C or acetaminophen and birth control pills is via a different pathway.
On the other hand, drugs that hasten the action of this liver enzyme (CYP3A4) may lead to increased clearance of the birth control pills from the body and loss of its effectiveness (contraceptive effect). These drug interactions may result in spotting, breakthrough bleeding, or unwanted pregnancy. Drugs that induce CYP3A4 and can cause contraceptive failure include carbamazepine (Tegretol), felbamate (Felbatol), griseofulvin (Fulvicin), oxcarbazepine (Trileptal), phenobarbital (Luminal, Barbita), phenytoin (Dilantin), primidone (Mysoline), rifampin (Rifadin), ritonavir (Norvir), topiramate (Topamax), and troglitazone (Rezulin). St. John's wort has recently been shown to induce CYP3A4, and the herbal preparation is likely to cause contraceptive failure, although formal case reports have not yet entered the literature. Some anticonvulsants/mood stabilizers such as valproate (Depakene, Depakote), gabapentin (Neurontin), lamotrigine (Lamictal), and vigabtrin (Sabril) have been shown NOT to increase birth control clearance.
Do not stop your birth control pills without consulting with your doctor.
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> Any women out there have experience with taking Ortho-Tri-Cyclan with meds like Prozac, Wellbutrin, Klonopin, and Trazadone (those are the meds I take.) Did anyone else have negative side effects while taking birth control pills with antidepressants, and if so did they go away? I feel tired, headachy, and ill most of the time since I started taking the birth control pills, and I feel like just throwing them away. Besides I heard my psychiatric meds make the birth control way less effective.
> > > >Ambrosia
poster:Sunnely
thread:63719
URL: http://www.dr-bob.org/babble/20010515/msgs/63761.html