Selective serotonin reuptake inhibitor (SSRI)
Escitalopram 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 Escitalopram (Escitalopram). The combination is generally fine at 5mg, 10mg, 20mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Escitalopram 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 Escitalopram acts on CYP3A4 determines whether Escitalopram affects contraception. Most agents in Selective serotonin reuptake inhibitor (SSRI) have no clinically meaningful effect on the pill at 5mg, 10mg, 20mg.
Practical guidance
According to the prescribing information for Escitalopram, women on hormonal contraception should review Escitalopram 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 Escitalopram therapy is the standard mitigation.
Frequently asked questions
Will Escitalopram make my pill less effective? ▾
Most Selective serotonin reuptake inhibitor (SSRI) medications at 5mg, 10mg, 20mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Escitalopram states whether the interaction is meaningful.
Do I need a backup contraceptive on Escitalopram? ▾
Backup contraception is needed only when there is a documented interaction between Escitalopram and the contraceptive method. For most users at 5mg, 10mg, 20mg, no backup is required. The pharmacist confirms whether Escitalopram interacts with hormonal contraception.
Products containing Escitalopram
More on Escitalopram
- With alcoholEscitalopram and alcohol — is it safe to drink?
- With foodShould Escitalopram be taken with food?
- Side effectsEscitalopram side effects: common, rare and warning signs
- Dosage guideEscitalopram dosage guide: how much to take and when
- OnsetHow fast does Escitalopram start working?
- DurationHow long does Escitalopram last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.