Lexapro 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 Lexapro (Escitalopram). The combination is generally fine at 5mg, 10mg, 20mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Lexapro 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 Escitalopram acts on CYP3A4 determines whether Lexapro affects contraception. Most agents in Anti-Depressants have no clinically meaningful effect on the pill at 5mg, 10mg, 20mg.
Practical guidance
According to the prescribing information for Escitalopram, women on hormonal contraception should review Lexapro 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 Lexapro therapy is the standard mitigation.
Frequently asked questions
Will Lexapro make my pill less effective? ▾
Most Anti-Depressants medications at 5mg, 10mg, 20mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Escitalopram states whether the interaction is meaningful.
Do I need a backup contraceptive on Lexapro? ▾
Backup contraception is needed only when there is a documented interaction between Lexapro and the contraceptive method. For most users at 5mg, 10mg, 20mg, no backup is required. The pharmacist confirms whether Escitalopram interacts with hormonal contraception.
More on Lexapro
- With alcoholLexapro and alcohol — is it safe to drink?
- With foodShould Lexapro be taken with food?
- Side effectsLexapro side effects: common, rare and warning signs
- Dosage guideLexapro dosage guide: how much to take and when
- OnsetHow fast does Lexapro start working?
- DurationHow long does Lexapro last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.