Does Minocycline Antibiotic Interact With My Birth Control Tri-Sprintec?

Our pharmacist answers the latest question regarding minocycline interacting with Tri-Sprintec.

Sep 25, 2017

Minnine asked

Does Minocycline interact with my birth control pills (Trisprintec)?

Answer

How antibiotics affect birth control medication is always a hot topic due to the possible severe consequences of an interaction.

The interaction is based mostly on the theory that since birth control pills partially reply on the normal bacteria flora in your gut to help metabolize and absorb estrogen in the body, altering that bacteria can lessen how effective the birth control is.

However, studies regarding this matter have continually shown that most antibiotics DO NOT cause any problems with hormonal contraceptive concentrations.

Most, if not all. of the studies come to the conclusion that most antibiotics (such as amoxicillin and minocycline) do not significantly change levels of oral contraceptives in the vast majority of patients and that back-up contraception is not necessary if contraceptives are used reliably during antibiotic use.

The only antibiotics class which causes an actual severe interaction with birth control is known as the rifamycin class of antibiotics. They greatly speed up how fast birth control is broken down in the liver. Fortunately, minocycline is not in that class.

Most of the studies relate to short term antibiotic use and during long-term antibiotic administration (as you are on), the risk for drug interaction is less clear. The best possibility to help reduce the risk of a possible interaction is to take a medium to high dose of a combined (both estrogen and progestin) contraceptive. Tri-Sprintec falls into that category.

Separating doses in the morning and evening may help matters, but there is no evidence stating that is a better way to go. Usually, that method works well if there is actual drug-drug interaction between two products. In this case, we are worried about an altered levels of bacteria in the gut, not two drugs interacting with each other. Long term administration will likely change the normal levels of bacteria in the gut for an extended period of time, so separating doses likely won't have much benefit. It does not hurt however so you may as well continue doing it.

So as far as a best recommendation, you are probably fine taking both your birth control and minocycline daily. Just make sure to stay consistent on the time you take your birth control. Always watch out for breakthrough bleeding, spotting and any similar side effects as that could indicate a fluctuation of your hormonal levels in the body.

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