Antibiotics+alcohol+birth control=?

March 29, 2008 11:57 PM

Antibiotics+alcohol+birth control=?

I am currently taking Yasmin and I'm near the end of my cycle (I start the placebos in two days). I have to take antibiotics twice a day for three days (I'm on the second day). I drank alcohol today and I had unprotected sex. Ridiculously stupid decision, I know.
I remembered that antibiotics supposedly don't work when you drink and birth control doesn't work when you're taking antibiotics. Does the alcohol cancel out the antibiotics which now won't effect the birth control? Should I wait until I'm done with the antibiotics and take a morning after pill on monday? What should I do?

posted by ad4pt to health & fitness (12 comments total)

I am not a medical anything, I have just taken antibiotics while on birth control and have been advised by medical professionals when I have done so. My understanding is this:

-Alcohol should be avoided when taking certain types of antibiotics such as metronidazole as they can cause severe reactions such as nausea and vomiting;
-Drinking doesn't actually affect the antibiotics' effectiveness, so they will still work when you drink. Alcohol can just lower energy levels and impair general healing;
-and only rifampin, an uncommonly used antibiotic has been shown in studies to cause interference with the effectiveness of birth control pills, but other antibiotics could theoretically interfere with oral contraceptives and you should use a backup method while taking antibiotics just in case.

So, don't freak out, go to the clinic on Monday, and get a morning-after pill. And buy some condoms to keep in your purse, just in case this situation happens again.
posted by bedhead at 12:16 AM on March 30, 2008 [1 favorite]

Check the labelling or info sheets for the particular antibiotic you're on- it'll tell you whether it interferes with birth control, and what the risks are for drinking while on it.

And if it doesn't say and you're still worried, call your doc (probably it can wait until monday, but that's not a guarantee). IANAD or a pharmacist.
posted by nat at 12:18 AM on March 30, 2008

According to Dr. Weil:

A widespread myth holds that you shouldn't drink alcohol while taking antibiotics, but in fact, drinking doesn't lessen the effects of the drugs. However, alcohol can lower your general energy and delay your recovery so it is best to minimize drinking until you've finished the prescribed course of antibiotic treatment. (Beyond that, chronic liver damage from excessive alcohol consumption can affect the metabolism and toxicity of antibiotics.)

posted by delmoi at 12:19 AM on March 30, 2008

Alcohol does not adversely affect all antibiotics; even in the event that the antibiotic you're currently taking is the type of antibiotic that would become less effective with alcohol consumption, the alcohol in your system certainly wouldn't be enough to negate an antibiotic's effect on the efficacy of your birth control.

Unless you want to chance it, I suggest the morning-after pill if you want to avoid the 9-months-after bundle of trouble.
posted by numinous at 12:22 AM on March 30, 2008

the alcohol in your system certainly wouldn't be enough to negate an antibiotic's effect on the efficacy of your birth control.

What effect? According to bedhead's link, only one specific and rare antibiotic (rifampin) actually affects birth control.

For the most part, all of these drugs affect separate things in the body. Obviously ad4pt should talk to her doctor, but I don't think there's any reason to worry. Of course, real birth control does fail every once in a while anyway.
posted by delmoi at 12:36 AM on March 30, 2008

Delmoi: From the link that bedhead posted:

Hypothetically speaking, other antibiotics, particularly penicillin and tetracycline derivatives, could impair the effectiveness of birth control pills. However, no large studies have proved such an effect. Researchers can't rule out the possibility that a small percentage of women may experience decreased effectiveness of birth control pills while taking an antibiotic. And if you're taking a newer, extremely low-dose oral contraceptive, you could be more susceptible to these potential effects from antibiotics. If you're concerned, consider using a barrier method of contraception for the duration of your antibiotic prescription.

Therefore, while there has been no study to prove that more common antibiotics definitively lessen the efficacy of oral contraceptives, the article makes clear that there is the potential for antibiotics to interfere with the efficacy of oral contraceptives. Clinical researchers are unable to "rule out the possibility" that any antibiotic could potentially interfere with birth control.

Given the fact that the OP did not specify exactly which birth control pill she takes (and therefore might be taking one of the "extremely low-dose oral [contraceptives]" mentioned in the Mayo Clinic FAQ), and also given the fact that the OP could be in the aforementioned "small percentage of women," it would be misleading and irresponsible not to suggest that she seek out some other means of protecting herself against pregnancy. Suggesting that she talk to her doctor may be good advice in certain scenarios, but in this situation, when the effectiveness of the morning-after pill is dependent upon its timely ingestion (no more than 72 hours after the unprotected sex), she may not have the time to talk to her doctor before the window of opportunity closes. Since she has already had unprotected sex, the logical course of action would be to obtain emergency contraception as soon as possible (as she cannot retroactively use the barrier method suggested by Mayo Clinic).

In the future, please read the linked article in full before you use it to sophistically support your argument.

Additionally, unless you, yourself, are a physician who understands the dynamics of contraception, it is irresponsible to suggest the the OP that there isn't "any reason to worry." She is obviously concerned about the possibility of being pregnant, and is looking to this community to guide her in a direction that would best prevent the occurrence of pregnancy, given the current context. She literally asks the question, "What should I do?" In this situation, it is obviously better to err on the side of caution, hence my suggestion that she obtain the morning-after pill.
posted by numinous at 1:36 AM on March 30, 2008

Alcohol should be avoided when taking certain types of antibiotics such as metronidazole

Nat is quite correct.
posted by Neiltupper at 2:43 AM on March 30, 2008

Every antibiotic I have ever been on (off the top of my head: arythromicin, doxycycline, amoxiciline, zithromicin) has come with a sticker on it saying it may decrease the effectiveness of birth control pills. Seriously. Go to a pharmacy and get Plan B. And this might be one of those times when people who have no knowledge on the subject ought not be answering AskMeFi questions.
posted by hydropsyche at 6:47 AM on March 30, 2008

This is purely anecdotal, and possibly a terrible answer:

I have been on antibiotics quite a few times in my 5 years on birth control. I have always been aware that their effectiveness was lowered, but never heeded the advice. (Stupid!)

I haven't turned up pregnant yet, I will tell you that much. I also suspect the fact that you are close to your placebo days means it should matter less. If you were going to ovulate, it wouldn't be now. obviously IANAD.

Anyway, this is possibly the worst advice ever, but I figured I should at least poke my head in and give it.
posted by sunshinesky at 7:17 AM on March 30, 2008

numinous Given the fact that the OP did not specify exactly which birth control pill she takes...

Sorry? Her first sentence after the break states precisely not only which pill she is taking, but where she is in her cycle.

I am currently taking Yasmin and I'm near the end of my cycle (I start the placebos in two days).

To the OP, I suspect your chances of being pregnant are fairly low, however better safe than sorry. Call your doctor or pharmacist first thing Monday. If you do need the morning after pill, you have a 72 hour window in which to take it so you'll be fine until Monday.
posted by goshling at 8:11 AM on March 30, 2008

Might not be a bad idea to skip the placebo week. If the antibiotics had weakened the birth control's effectiveness, it would be just like you'd started the placebo two days early. Add this to the week of real placebo and you've got 9 days of no hormone, which might be long enough to allow you to ovulate. If, on the other hand, you skip the placebo week, you've got max two days without hormone. And you do more than that every month!
posted by wyzewoman at 8:26 AM on March 30, 2008

I had a pharmacist and a gynecologist independently tell me that the antibiotics-breaks-birth-control thing is a superstition more than a fact, and that I shouldn't worry my pretty little head about it. My gynecologist at the time basically said that she always approves of couples using a barrier method as well as a hormonal method and that whether or not I was on antibiotics doesn't change how much she does or doesn't approve of skipping the latex. Still, if I were you, depending on how horrible an accidental pregnancy would be for you I'd probably hit up some morning after pills.
posted by crinklebat at 8:06 PM on March 30, 2008