Evista 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 Evista (Raloxifene). The combination is generally fine at 60mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Evista 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 Raloxifene acts on CYP3A4 determines whether Evista affects contraception. Most agents in Hormones and Birth Control have no clinically meaningful effect on the pill at 60mg.
Practical guidance
According to the prescribing information for Raloxifene, women on hormonal contraception should review Evista 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 Evista therapy is the standard mitigation.
Frequently asked questions
Will Evista make my pill less effective? ▾
Most Hormones and Birth Control medications at 60mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Raloxifene states whether the interaction is meaningful.
Do I need a backup contraceptive on Evista? ▾
Backup contraception is needed only when there is a documented interaction between Evista and the contraceptive method. For most users at 60mg, no backup is required. The pharmacist confirms whether Raloxifene interacts with hormonal contraception.
More on Evista
- With alcoholEvista and alcohol — is it safe to drink?
- With foodShould Evista be taken with food?
- Side effectsEvista side effects: common, rare and warning signs
- Dosage guideEvista dosage guide: how much to take and when
- OnsetHow fast does Evista start working?
- DurationHow long does Evista last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.