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Selective estrogen receptor modulator (SERM)

Raloxifene 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 Raloxifene (Raloxifene). The combination is generally fine at 60mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Raloxifene 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 Raloxifene acts on CYP3A4 determines whether Raloxifene affects contraception. Most agents in Selective estrogen receptor modulator (SERM) have no clinically meaningful effect on the pill at 60mg.

Practical guidance

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

Frequently asked questions

Will Raloxifene make my pill less effective?

Most Selective estrogen receptor modulator (SERM) medications at 60mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Raloxifene states whether the interaction is meaningful.

Do I need a backup contraceptive on Raloxifene?

Backup contraception is needed only when there is a documented interaction between Raloxifene and the contraceptive method. For most users at 60mg, no backup is required. The pharmacist confirms whether Raloxifene 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.