Diflucan with the birth control pill
Many women of reproductive age take a combined or progestogen-only oral contraceptive while also using a chronic medication such as Diflucan (Fluconazole). The combination is generally fine at 50mg, 100mg, 150mg, 200mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Diflucan can affect contraceptive efficacy
Combined and progestogen-only contraceptives are metabolised through CYP3A4. Strong CYP3A4 inducers (some antiepileptics, rifampicin, St John's Wort) lower contraceptive plasma levels and reduce efficacy. Whether Fluconazole acts on CYP3A4 determines whether Diflucan affects contraception. Most agents in Antifungal Medications have no clinically meaningful effect on the pill at 50mg, 100mg, 150mg, 200mg.
Practical guidance
According to the prescribing information for Fluconazole, women on hormonal contraception should review Diflucan with the prescribing pharmacist or doctor. Where an interaction is documented, additional barrier contraception or switching to a non-oral method (IUD, implant) for the duration of Diflucan therapy is the standard mitigation.
Frequently asked questions
Will Diflucan make my pill less effective? ▾
Most Antifungal Medications medications at 50mg, 100mg, 150mg, 200mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Fluconazole states whether the interaction is meaningful.
Do I need a backup contraceptive on Diflucan? ▾
Backup contraception is needed only when there is a documented interaction between Diflucan and the contraceptive method. For most users at 50mg, 100mg, 150mg, 200mg, no backup is required. The pharmacist confirms whether Fluconazole interacts with hormonal contraception.
More on Diflucan
- With alcoholDiflucan and alcohol — is it safe to drink?
- With foodShould Diflucan be taken with food?
- Side effectsDiflucan side effects: common, rare and warning signs
- Dosage guideDiflucan dosage guide: how much to take and when
- OnsetHow fast does Diflucan start working?
- DurationHow long does Diflucan last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.