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Prostaglandin E1 (PGE1)

Alprostadil 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 Alprostadil (Alprostadil). The combination is generally fine at 10mcg, 20mcg, 40mcg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Alprostadil 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 Alprostadil acts on CYP3A4 determines whether Alprostadil affects contraception. Most agents in Prostaglandin E1 (PGE1) have no clinically meaningful effect on the pill at 10mcg, 20mcg, 40mcg.

Practical guidance

According to the prescribing information for Alprostadil, women on hormonal contraception should review Alprostadil 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 Alprostadil therapy is the standard mitigation.

Frequently asked questions

Will Alprostadil make my pill less effective?

Most Prostaglandin E1 (PGE1) medications at 10mcg, 20mcg, 40mcg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Alprostadil states whether the interaction is meaningful.

Do I need a backup contraceptive on Alprostadil?

Backup contraception is needed only when there is a documented interaction between Alprostadil and the contraceptive method. For most users at 10mcg, 20mcg, 40mcg, no backup is required. The pharmacist confirms whether Alprostadil interacts with hormonal contraception.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.