Proton pump inhibitor
Esomeprazole 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 Esomeprazole (Esomeprazole). The combination is generally fine at 20mg, 40mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Esomeprazole 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 Esomeprazole acts on CYP3A4 determines whether Esomeprazole affects contraception. Most agents in Proton pump inhibitor have no clinically meaningful effect on the pill at 20mg, 40mg.
Practical guidance
According to the prescribing information for Esomeprazole, women on hormonal contraception should review Esomeprazole 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 Esomeprazole therapy is the standard mitigation.
Frequently asked questions
Will Esomeprazole make my pill less effective? ▾
Most Proton pump inhibitor medications at 20mg, 40mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Esomeprazole states whether the interaction is meaningful.
Do I need a backup contraceptive on Esomeprazole? ▾
Backup contraception is needed only when there is a documented interaction between Esomeprazole and the contraceptive method. For most users at 20mg, 40mg, no backup is required. The pharmacist confirms whether Esomeprazole interacts with hormonal contraception.
Products containing Esomeprazole
More on Esomeprazole
- With alcoholEsomeprazole and alcohol — is it safe to drink?
- With foodShould Esomeprazole be taken with food?
- Side effectsEsomeprazole side effects: common, rare and warning signs
- Dosage guideEsomeprazole dosage guide: how much to take and when
- OnsetHow fast does Esomeprazole start working?
- DurationHow long does Esomeprazole last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.