Macrolide antibiotic
Azithromycin 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 Azithromycin (Azithromycin). The combination is generally fine at 250mg, 500mg, 600mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Azithromycin 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 Azithromycin acts on CYP3A4 determines whether Azithromycin affects contraception. Most agents in Macrolide antibiotic have no clinically meaningful effect on the pill at 250mg, 500mg, 600mg.
Practical guidance
According to the prescribing information for Azithromycin, women on hormonal contraception should review Azithromycin 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 Azithromycin therapy is the standard mitigation.
Frequently asked questions
Will Azithromycin make my pill less effective? ▾
Most Macrolide antibiotic medications at 250mg, 500mg, 600mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Azithromycin states whether the interaction is meaningful.
Do I need a backup contraceptive on Azithromycin? ▾
Backup contraception is needed only when there is a documented interaction between Azithromycin and the contraceptive method. For most users at 250mg, 500mg, 600mg, no backup is required. The pharmacist confirms whether Azithromycin interacts with hormonal contraception.
Products containing Azithromycin
More on Azithromycin
- With alcoholAzithromycin and alcohol — is it safe to drink?
- With foodShould Azithromycin be taken with food?
- Side effectsAzithromycin side effects: common, rare and warning signs
- Dosage guideAzithromycin dosage guide: how much to take and when
- OnsetHow fast does Azithromycin start working?
- DurationHow long does Azithromycin last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.