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