Gabapentinoid (alpha-2-delta ligand)
Pregabalin 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 Pregabalin (Pregabalin). The combination is generally fine at 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Pregabalin 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 Pregabalin acts on CYP3A4 determines whether Pregabalin affects contraception. Most agents in Gabapentinoid (alpha-2-delta ligand) have no clinically meaningful effect on the pill at 25mg, 50mg, 75mg, 100mg, 150mg, 200mg.
Practical guidance
According to the prescribing information for Pregabalin, women on hormonal contraception should review Pregabalin 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 Pregabalin therapy is the standard mitigation.
Frequently asked questions
Will Pregabalin make my pill less effective? ▾
Most Gabapentinoid (alpha-2-delta ligand) medications at 25mg, 50mg, 75mg, 100mg, 150mg, 200mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Pregabalin states whether the interaction is meaningful.
Do I need a backup contraceptive on Pregabalin? ▾
Backup contraception is needed only when there is a documented interaction between Pregabalin and the contraceptive method. For most users at 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, no backup is required. The pharmacist confirms whether Pregabalin interacts with hormonal contraception.
Products containing Pregabalin
More on Pregabalin
- With alcoholPregabalin and alcohol — is it safe to drink?
- With foodShould Pregabalin be taken with food?
- Side effectsPregabalin side effects: common, rare and warning signs
- Dosage guidePregabalin dosage guide: how much to take and when
- OnsetHow fast does Pregabalin start working?
- DurationHow long does Pregabalin last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.