Serotonin-norepinephrine reuptake inhibitor (SNRI)
Duloxetine 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 Duloxetine (Duloxetine). The combination is generally fine at 20mg, 30mg, 60mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Duloxetine 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 Duloxetine acts on CYP3A4 determines whether Duloxetine affects contraception. Most agents in Serotonin-norepinephrine reuptake inhibitor (SNRI) have no clinically meaningful effect on the pill at 20mg, 30mg, 60mg.
Practical guidance
According to the prescribing information for Duloxetine, women on hormonal contraception should review Duloxetine 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 Duloxetine therapy is the standard mitigation.
Frequently asked questions
Will Duloxetine make my pill less effective? ▾
Most Serotonin-norepinephrine reuptake inhibitor (SNRI) medications at 20mg, 30mg, 60mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Duloxetine states whether the interaction is meaningful.
Do I need a backup contraceptive on Duloxetine? ▾
Backup contraception is needed only when there is a documented interaction between Duloxetine and the contraceptive method. For most users at 20mg, 30mg, 60mg, no backup is required. The pharmacist confirms whether Duloxetine interacts with hormonal contraception.
Products containing Duloxetine
More on Duloxetine
- With alcoholDuloxetine and alcohol — is it safe to drink?
- With foodShould Duloxetine be taken with food?
- Side effectsDuloxetine side effects: common, rare and warning signs
- Dosage guideDuloxetine dosage guide: how much to take and when
- OnsetHow fast does Duloxetine start working?
- DurationHow long does Duloxetine last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.