Contraceptives

Low Dose Birth Control is helping lots of women control their acne but in really severe cases of this condition, Accutane may be prescribed, which can cause birth defects if you become pregnant while on it- this means that you are taking a huge risk if you rely SOLELY  on your low dose birth control method to stop you from getting pregnant.

The excerpt below is from a recent article I found on treating acne and if you take Accutane for this condition, as well as some form of low dose birth control to prevent pregnancy, please read the warnings.  Hopefully your doctor will already have warned you that it is VITAL that you do get pregnant while taking Accutane.  It is your responsibility to make sure that you ‘double up’ by using an additional method of contraception along with your low dose birth control.

If you have questions after reading this excerpt, you know what to do- go back and discuss your birth control regime with your doctor.

TIP: Always have a pregnancy test kit on hand while you are taking Accutane.

Excerpt:

“What are the important warnings for females taking Accutane?

You must not become pregnant while taking Accutane, or for 1 month after you stop taking Accutane. Accutane can cause severe birth defects in babies of women who take it while they are pregnant, even if they take Accutane for only a short time. There is an extremely high risk that your baby will be deformed or will die if you are pregnant while taking Accutane. Taking Accutane also increases the chance of miscarriage and premature births.

Female patients will not get their first prescription for Accutane unless there is proof they have had 2 negative pregnancy tests. The first test must be done when your prescriber decides to prescribe Accutane. The second pregnancy test must be done during the first 5 days of the menstrual period right before starting Accutane therapy, or as instructed by your prescriber. Each month of treatment, you must have a negative result from a urine or serum pregnancy test. Female patients cannot get another prescription for Accutane unless there is proof that they have had a negative pregnancy test.

A yellow self-adhesive Accutane Qualification Sticker on your prescription indicates to the pharmacist that you are qualified by your prescriber to get Accutane.

While you are taking Accutane, you must use effective birth control. You must use 2 separate effective forms of birth control at the same time for at least 1 month before starting Accutane, while you take it, and for 1 month after you stop taking it. You can either discuss effective birth control methods with your prescriber or go for a free visit to discuss birth control with another physician or family planning expert. Your prescriber can arrange this free visit, which will be paid for by the manufacturer.

You must use 2 separate forms of effective birth control because any method, including birth control pills and sterilization, can fail. There are only 2 reasons you would not need to use 2 separate methods of effective birth control:

1. You have had your womb removed by surgery (a hysterectomy).
2. You are absolutely certain you will not have genital-to-genital sexual contact with a male before, during, and for 1 month after Accutane treatment.

If you have sex at any time without using 2 forms of effective birth control, get pregnant, or miss your period, stop using Accutane and call your prescriber right away.

I recommend that all patients should read the rest of this Medication Guide. Here’s the link to the FULL article

Your perfect partner has been diagnosed with Chlamydiosis and thinks he is ‘doing the right thing’ by passing on a prescription for you from his doctor for an STI med- what he doesn’t know is that this medication may not be the perfect partner for your low dose birth control!  In cases where doctors believe that a patient’s partner will not or is unable to, seek treatment for an STI, they will provide EPT (Expedited partner therapy) along with some resource material for follow up and testing.  Don’t just take your partners word for it that all will be ’sweet’ if you just take the meds.

What is EPT ?

The Centers for Disease Control and Prevention, define EPT as  “the practice of treating sex partners of patients with sexually transmitted diseases without an intervening medical evaluation or professional prevention counseling.” Not all states have the same regulations about EPT but each doctor should be aware of their own state’s ruling.

Using the same antibiotic medication as your partner for an STI can be effective if you have the same STI as your partner and DO NOT have a pelvic infection or another type of STI such as syphilis, trichomoniasis or HIV.  Additional treatment is available for these diseases but  it’s always smart to go to your doc or a clinic as soon as your partner tells you he’s infected with an STI.  Don’t let it get to the ‘confessional stage’ though before you get checked out anyway, especially if you have more than one sex partner.  If he does sheepishly slip you that prescription, it should come with some extra written information about allergies, Q&As and some guidance about other STIs - read it THEN go to the doctor  because…..
The ‘downside’ for you if your partner hands you an STI medication prescription is that, unless your partner is one in a million, he will not be able to tell his doctor about any of your food allergies, other meds you take or your medical history- any of which could prevent the STI medication from being prescribed for your use.  With the best intention in the world, your partner could be putting you both at risk- especially if you are taking a low dose birth control pill.
IF you are taking low dose birth control pills and you also take the doses of doxycycline that you got with that extra prescription your partner brought home for you AND you continue to be sexually active, you may become pregnant due to the interaction between the two medications- go see your doctor soon.

If you use the low dose birth control pill Yasmin, this pharmacy has by far the best price for the cheaper, generic version called Janya

I LOVE all things grapefruit but after reading the package leaflet of my Lipitor medication I have abstained from enjoying even a glass of the delicious juice. Why? Simply because grapefruit can reduce the effectiveness of Lipitor.  Damn it……grapefruit can also reduce the effectiveness of your combined low dose birth control pill too. You’re OK if you take the progestin only pills - they are not affected by grapefruit as they do not contain estrogen.

Apparently, grapefruit and its juice hinders the absorption of estrogen in the body -  not a good thing if you’re paying out for a reliable birth control method that contains estrogen.  We need maximum estrogen absorption from our oral contraceptive pill to stop us from getting pregnant. In the previous post I listed other ‘compounds’ that can reduce the effectiveness of an oral contraceptive pill. The jury is still out on whether taking antihistamines alongside birth control pills containing estrogen may also affect  the performance of the pill. Anticonvulsants and antifungal medications should also be checked out with your doctor.

What happens in my body when I combine grapefruit and drugs?

There is a certain enzyme in your intestines and liver that help you to absorb  the drugs that you swallow and then excrete them when you’re body’s got what it can from them. Normally your doctor will prescribe a quantity/dose of a drug that is appropriate for
your body mass. This dose, say 40mg, should be absorbed into your body at a certain rate and excreted at a certain rate.  Enzymes in your gastrointestinal tract (gut) break down food and oral medications to enable them to be easily absorbed into your body.

Grapefruit juice seems to affect both the rate of the drug coming into your body and how quickly it is removed. The end result can be an overdose of the drug, even if you’re taking the correct dosage for your size. Where estrogen is the ‘active’ hormone that prevents pregnancy, you would be risking reducing the AMOUNT that your body would absorb and therefore ‘reducing’ your maximum protection.

What Can I Do To Avoid Dangerous Drug Interactions? Eat oranges instead!

If you are on medications that interact with grapefruit, unfortunately, like me, you’ll just have to avoid eating grapefruit or drinking grapefruit juice. If you think you can cheat by having grapefruit for brekky and taking your contraceptive pill at bedtime,  you’re out of luck as this will NOT solve the problem; the grapefruit juice effect remains even after you’ve stopped having it. Oranges are looking pretty good at this point if you like a ‘fresh’ start to your day.  A can of tomato juice has just 41 calories and more than
70% of the vitamin C for the day.

In the same way that your other medication can affect your birth control, remember that your birth control can also affect your other medication. Avoiding negative drug interactions is important whichever way you look at it so always ask your doctor or
pharmacist about drug interactions when you get a new prescription.

NB.These interactions apply to other methods of hormonal birth control including the Patch, the vaginal ring and Depo-Provera.

Alesse is a combined, low dose oral contraceptive pill that is very effective in preventing pregnancy when taken correctly.  However, did you know that certain other drugs, when taken alongside Alesse or other oral contraceptive pills, can reduce this effectiveness and possibly increase your risk of getting pregnant?  Alesse or any other low dose oral contraceptive pill that contains ethinyl estradiol and levonorgestrel may react with any of the drugs listed below so please carefully check the package list of ‘active ingredients’ on ANY medications you are taking alongside Alesse. A quick call to your doctor or pharmacist will put your mind at ease.

NB. This includes herbal products, vitamins and minerals, over the counter medications such as pain killers, sleeping pills and other prescriptions you have filled. Check with your doctor if you use illegal drugs alongside Alesse and if you are a heavy drinker of alcohol or smoke to excess.

acetaminophen (Tylenol) or ascorbic acid (vitamin C)
•anastrozole
•antibiotics or medicines for infections, especially rifampin
•aprepitant
•barbiturate medicines for producing sleep or treating seizures (convulsions)secobarbital (Seconal), or phenobarbital (Luminal, Solfoton)
•bosentan
•carbamazepine (Tegretol)
•caffeine
•clofibrate
•cyclosporine (Neoral, Sandimmune, Gengraf)
•dantrolene
•doxercalciferol
•exemestane
•grapefruit juice- stay tuned for more information on this in another post
•hydrocortisone
•letrozole
•medicines for anxiety or sleeping problems, such as diazepam or temazepam
•medicines for mental depression
•medicines for diabetes, including troglitazone and pioglitazone
•mineral oil
•modafinil
•mycophenolate
•nefazodone
•oxcarbazepine
phenylbutazone (Azolid, Butazolidin)
•phenytoin (Dilantin)
•prednisolone (Orapred)
primidone (Mysoline)
rifampin
•ritonavir (Norvir)or other medicines for the treatment of the HIV virus or AIDS such as modafinil (Provigil)
•selegiline
•soy isoflavones supplements
•St. John’s wort (Hypericum perforatum)
•tamoxifen or raloxifene
•testolactone
•theophylline (Respbid, Theo-Dur)
•topiramate (Topamax)
•warfarin

………..and possibly certain antibiotics (such as ampicillin and other penicillins and tetracyclines)

WARNING: Do not share Alesse or any other oral contraceptive pill with anyone else and keep the pack of oral contraceptive pills out of the reach of children. Do not use Alesse or any other medication after the expiry date on the pack.
Sources: Wyeth Pharmaceuticals Inc.Philadelphia, DrugDigest, Drugs.com

The above information is intended as a guide only and should not be substituted for the professional expertise and advice from your doctor or pharmacist.