Elavil 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 Elavil (Amitriptyline). The combination is generally fine at 10mg, 25mg, 50mg, 75mg, 100mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Elavil 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 Amitriptyline acts on CYP3A4 determines whether Elavil affects contraception. Most agents in Anti-Depressants have no clinically meaningful effect on the pill at 10mg, 25mg, 50mg, 75mg, 100mg.
Practical guidance
According to the prescribing information for Amitriptyline, women on hormonal contraception should review Elavil 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 Elavil therapy is the standard mitigation.
Frequently asked questions
Will Elavil make my pill less effective? ▾
Most Anti-Depressants medications at 10mg, 25mg, 50mg, 75mg, 100mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Amitriptyline states whether the interaction is meaningful.
Do I need a backup contraceptive on Elavil? ▾
Backup contraception is needed only when there is a documented interaction between Elavil and the contraceptive method. For most users at 10mg, 25mg, 50mg, 75mg, 100mg, no backup is required. The pharmacist confirms whether Amitriptyline interacts with hormonal contraception.
More on Elavil
- With alcoholElavil and alcohol — is it safe to drink?
- With foodShould Elavil be taken with food?
- Side effectsElavil side effects: common, rare and warning signs
- Dosage guideElavil dosage guide: how much to take and when
- OnsetHow fast does Elavil start working?
- DurationHow long does Elavil last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.