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Selective estrogen receptor modulator (ovulation induction)

Clomiphene 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 Clomiphene (Clomiphene). The combination is generally fine at 50mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Clomiphene 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 Clomiphene acts on CYP3A4 determines whether Clomiphene affects contraception. Most agents in Selective estrogen receptor modulator (ovulation induction) have no clinically meaningful effect on the pill at 50mg.

Practical guidance

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

Frequently asked questions

Will Clomiphene make my pill less effective?

Most Selective estrogen receptor modulator (ovulation induction) medications at 50mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Clomiphene states whether the interaction is meaningful.

Do I need a backup contraceptive on Clomiphene?

Backup contraception is needed only when there is a documented interaction between Clomiphene and the contraceptive method. For most users at 50mg, no backup is required. The pharmacist confirms whether Clomiphene 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.