Lack of Influence of Ciprofloxacin on the Effectiveness of Oral Contraceptives

Droppert, R. M.; Scholten, Piet C.; Zwinkels, M.; Hoepelman, I. M.; Velde, E.R. te

doi:10.2165/00003495-199300453-00102

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…For adverse health effects, a third study reported that 15 women with previously normal cycles on OCs reported no breakthrough bleeding after taking oxtetracycline (500 mg 4 times daily). 10 Fluoroquinolones and OCs ( ajog.org 23,24 One trial reported no breakthrough bleeding in OC cycles with and without ciprofloxacin. 25 Two additional trials reported no ovulation by serum progesterone and/or monitoring of follicles on ultrasound scanning in OC cycles with and without temafloxacin or ofloxacin.…”

Section: Tetracyclines and Ocs (Table 2; Appendix D)mentioning

confidence: 99%

“…2 Surrogate markers of contraceptive effectiveness in this review also support no interaction between the use of nonrifamycin antibiotics and HC. Although most ovulation outcomes were secondary and often underpowered (Appendices CeG), no differences in ovulation by serum progesterone or ultrasound scanning were observed in any study that combined OCs with ampicillin, [15][16][17] doxycycline, 22 temafloxacin, 27 ofloxacin, 26 ciprofloxacin, 23,24 clarithromycin, 31 roxithromycin, 30 dirithromycin, 32 or metronidazole. 17 Likewise, breakthrough bleeding was either no different than control or inconclusive in combination with ampicillin, 10 oxtetracycline, 10 ciprofloxacin, 25 dirithromycin, 32 roxithromycin, 30 nitrofurantoin, 10 or trimethoprim/sulfamethoxazole.…”

Section: Commentmentioning

confidence: 99%

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Drug interactions between non-rifamycin antibiotics and hormonal contraception: a systematic review

Simmons

Haddad

Nanda

et al. 2018

American Journal of Obstetrics and Gynecology

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Section: Tetracyclines and Ocs (Table 2; Appendix D)mentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Drug interactions between non-rifamycin antibiotics and hormonal contraception: a systematic review

Simmons

Haddad

Nanda

et al. 2018

American Journal of Obstetrics and Gynecology

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show abstract

“…progesterone and no difference in ovarian activity by ultrasound scanning in OC cycles with and without ciprofloxacin. 23,24 One trial reported no breakthrough bleeding in OC cycles with and without ciprofloxacin. 25 Two additional trials reported no ovulation by serum progesterone and/or monitoring of follicles on ultrasound scanning in OC cycles with and without temafloxacin or ofloxacin.…”

Section: Tetracyclines and Ocs (Table 2; Appendix D)mentioning

confidence: 99%

Drug Interactions Between Non-Rifamycin Antibiotics and Hormonal Contraception: A Systematic Review

Simmons¹,

Haddad

Nanda

et al. 2018

Obstetrical &Amp; Gynecological Survey

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The purpose of this study was to determine whether interactions between non-rifamycin antibiotics and hormonal contraceptives result in decreased effectiveness or increased toxicity of either therapy. STUDY DESIGN: We searched MEDLINE, Embase, clinicaltrials.gov, and Cochrane libraries from database inception through June 2016. We included trials, cohort, casecontrol, and pharmacokinetic studies in any language that addressed pregnancy rates, pharmacodynamics, or pharmacokinetic outcomes when any hormonal contraceptive and non-rifamycin antibiotic were administered together vs apart. Of 7291 original records that were identified, 29 met criteria for inclusion. STUDY APPRAISAL AND SYNTHESIS METHODS: Two authors independently assessed study quality and risk of bias using the United States Preventive Services Task Force evidence grading system. Findings were tabulated by drug class. RESULTS: Study quality ranged from good to poor and addressed only oral contraceptive pills, emergency contraception pills, and the combined vaginal ring. Two studies demonstrated no difference in pregnancy rates in women who used oral contraceptives with and without non-rifamycin antibiotics. No differences in ovulation suppression or breakthrough bleeding were observed in any study that combined hormonal contraceptives with any antibiotic. No significant decreases in any progestin pharmacokinetic parameter occurred during co-administration with any antibiotic. Ethinyl estradiol area under the curve decreased when administered with dirithromycin, but no other drug. CONCLUSION: Evidence from clinical and pharmacokinetic outcomes studies does not support the existence of drug interactions between hormonal contraception and nonrifamycin antibiotics. Data are limited by low quantity and quality for some drug classes. Most women can expect no reduction in hormonal contraceptive effect with the concurrent use of non-rifamycin antibiotics.

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