Prilosec 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 Prilosec (Omeprazole). The combination is generally fine at 10mg, 20mg, 40mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Prilosec 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 Omeprazole acts on CYP3A4 determines whether Prilosec affects contraception. Most agents in Gastrointestinal Medications have no clinically meaningful effect on the pill at 10mg, 20mg, 40mg.
Practical guidance
According to the prescribing information for Omeprazole, women on hormonal contraception should review Prilosec 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 Prilosec therapy is the standard mitigation.
Frequently asked questions
Will Prilosec make my pill less effective? ▾
Most Gastrointestinal Medications medications at 10mg, 20mg, 40mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Omeprazole states whether the interaction is meaningful.
Do I need a backup contraceptive on Prilosec? ▾
Backup contraception is needed only when there is a documented interaction between Prilosec and the contraceptive method. For most users at 10mg, 20mg, 40mg, no backup is required. The pharmacist confirms whether Omeprazole interacts with hormonal contraception.
More on Prilosec
- With alcoholPrilosec and alcohol — is it safe to drink?
- With foodShould Prilosec be taken with food?
- Side effectsPrilosec side effects: common, rare and warning signs
- Dosage guidePrilosec dosage guide: how much to take and when
- OnsetHow fast does Prilosec start working?
- DurationHow long does Prilosec last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.