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Selective serotonin reuptake inhibitor (SSRI)

Sertraline 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 Sertraline (Sertraline). The combination is generally fine at 25mg, 50mg, 100mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.

How Sertraline 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 Sertraline acts on CYP3A4 determines whether Sertraline affects contraception. Most agents in Selective serotonin reuptake inhibitor (SSRI) have no clinically meaningful effect on the pill at 25mg, 50mg, 100mg.

Practical guidance

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

Frequently asked questions

Will Sertraline make my pill less effective?

Most Selective serotonin reuptake inhibitor (SSRI) medications at 25mg, 50mg, 100mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Sertraline states whether the interaction is meaningful.

Do I need a backup contraceptive on Sertraline?

Backup contraception is needed only when there is a documented interaction between Sertraline and the contraceptive method. For most users at 25mg, 50mg, 100mg, no backup is required. The pharmacist confirms whether Sertraline 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.