Dangerous interactions of oral contraceptives with medicines, drinks, food. What weakens the effect of hormonal contraceptives

If possible, you should avoid taking other medicines or herbal medicines together with birth control pills. If you are prescribed a medication, you should always tell your doctor if you are using it as contraception. This is important because some medicines can make birth control pills less effective. For example, some antibiotics can make birth control pills (birth control pills) less effective. So, there is evidence of pregnancy in women who took antibiotics while using birth control pills.

In theory, additional drugs can alter the metabolism of synthetic hormones in the blood, thereby altering their effectiveness. Antibiotics can interfere with the metabolism of estrogen (the active ingredient in birth control pills). At the same time, the effectiveness of the contraceptive may decrease, and there will be a need to take backup methods of contraception, such as, for example, condoms. You must use additional contraception while you are taking antibiotics and for the first week after you stop taking them.

Some antibiotics can interact with birth control pills, making them less effective, and the risk of unintended pregnancy increases dramatically. A visual marker of a decrease in the effectiveness of contraceptives can be the so-called "bleeding in the middle of the cycle."
Antibiotics that reduce the effectiveness of oral contraceptives: rifampicin, and to a lesser extent penicillin, amoxicillin, ampicillin, sulfamethoxazole / trimethoprim, tetracycline, minocycline, metronidazole, and nitrofurantoin.

Phenytoin and barbiturates also reduce the effectiveness of oral contraceptives and can cause bleeding mid-cycle.

Tips for women who should take antibiotics while using birth control pills

To prevent pregnancy, when taking contraceptive pills and antibiotics together, it is necessary to use contraceptive methods (condoms or spermicides) during the entire period of taking antibiotics and during the first week after completion of treatment.

There are two types of combined contraceptive packs: a 21-day pack, followed by a weekly break, and a 28-day pack, the last 7 tablets of which are hormone-free. If you are taking antibiotics, then in the case of the 21-day pack, the 7-day break should not be taken, you must immediately start the next pack. In the case of the 28-day pack, you should not drink 7 inactive tablets (without hormones, they are of a different color), but you should immediately go to the active tablets from the next pack.

Antibiotics can interact with birth control pills, making them less effective. You must use additional contraception during and after antibiotic therapy (at least one more week)

If you are taking antibiotics within the first seven days of your new pack and have had sexual intercourse in the last 5-7 days, you should see your doctor because you may need emergency contraception as there is a chance of an unplanned pregnancy.
If you have been prescribed antibiotics for more than two weeks, you may need additional counseling. Your healthcare provider should be able to provide it.

Pills and some other contraceptives (patches, spirals, injections) usually contain the female sex hormones estrogen and progestin. They prevent ovulation and pregnancy. But some medications prevent hormones from doing their job. If taken simultaneously with COCs, the effect of the contraceptive may decrease, and in some cases, more serious consequences for the woman's health occur.

WHAT PREPARATIONS SHOULD NOT BE TAKEN AT THE SAME TIME WITH HORMONAL CONTRACEPTIVES

Antibiotics and OK

A course of antibiotics may be necessary for infections caused by bacteria (pneumonia, sinusitis, acne, urinary tract infections, etc.). In most cases, antibiotic medications can be combined with OC. The only antibiotic that interacts negatively with hormonal contraceptives is rifampin(Rifadin, Rifadin). This drug is used to treat tuberculosis and may cause irregular periods.

Rifampin reduces the effectiveness of hormones by decreasing the effects of ethinyl estradiol and progestin in women taking oral contraceptives. Rifampin can also reduce the effectiveness of a transdermal contraceptive patch (Ortho Evra, etc.) and a vaginal ring (NuvaRing, etc.), in which case you will have to use an additional method of contraception.

It used to be thought that any antibiotics could reduce the effectiveness of COCs. However, recent studies have shown that they do not affect oral contraceptive use. The most popular antibiotics - ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, tetracycline - can be used in conjunction with COCs.

HIV drugs and hormones

Some medicines that are prescribed for HIV can interfere with the normal functioning of the OK. These include Darunavir(Prezista), Efavirenz(Sustiva) Lopinavir / Ritonavir(Kaletra), Nevirapine(Viramune). To adjust therapy or prescribe another contraceptive, you need to consult your doctor.

Antifungal drugs

Griseofulvin(Griseofulvin, Gris-PEG) is used to treat skin infections such as an athlete's leg (athlete's foot) and itchy groin. Ketoconazole(Nizoral and others) are used mainly when other antifungal drugs are not available or do not help. Scientists believe these drugs may interfere with the effectiveness of the birth control pill (low risk).

Anti-seizure drugs and hormonal pills for women

Some of the anticonvulsants disrupt hormonal balance, making birth control pills less effective. These drugs include Carbamazepine(Carbatrol, Epitol, Equitro, Tegretol), Felbamat(Felbatol), Oxcarbazepine(trileptal) Phenobarbital(Luminal), Phenytoin(Dilantin, Phenytek), Primidon(Mysoline), Topiramate(Topamax).

Analeptics for hormonal contraception

Modafinil(Provigil) is a stimulant commonly used to treat symptoms of sleep disorders such as narcolepsy and apnea. Research shows that this drug reduces the effectiveness of OCs. Use a different method of birth control while you are taking modafinil (Provigil) and for a month after stopping it.

Pain relievers

Over-the-counter pain relievers may work less well when a woman is on birth control pills.

In addition, the instructions for analgin it is indicated that oral contraceptives disrupt its metabolism in the liver, due to which the toxicity of analgin increases.

Blood pressure lowering drugs

Certain medicines for high blood pressure (for example, cyclopentiazide) may also work worse if the woman drinks OK.

Asthma remedies

Birth control pills can increase the side effects and toxic effects of some asthma medications (for example, theophylline).

Tranquilizers and antidepressants

A side effect of some of these drugs is benzodiazepam and imipramine- may also be stronger due to interactions with COCs.

Laxatives

If there is a need to take these medications, then it is better to do it in advance or at least 2 hours after taking OK, so that oral contraceptives have time to be absorbed.

Iron

Iron is generally not recommended when taking birth control pills. Against the background of OK, women most often experience scant bleeding, and the level of iron in the blood remains normal.

If you develop severe bleeding while taking COCs and / or you suspect you have iron deficiency anemia, get tested and consult your doctor.

Excess iron can be toxic to the body, causing upset stomach, abdominal pain, vomiting, and darkening of the skin.

Vitamin C

It is undesirable to combine the reception of OK with ascorbic acid. However, at the same time due to hormonal pills may occur. If you want to drink vitamins during the course of hormones, do it at different times (with an interval of several hours between taking OK and vitamins).

FOOD AND BEVERAGES THAT ARE NOT COMBINED WITH HORMONAL TABLETS

Alcohol

Usually alcohol does not affect OK in any way. However, if vomiting occurs from alcohol and less than 2 hours have passed after taking hormones, the effectiveness of COCs may be reduced. If this happens, take another pill as soon as possible and contact your doctor right away.

Grapefruit

Chemicals in grapefruit (fruit and juice) interfere with the CYP3A4 enzyme in the gut from absorbing certain medications. This leads to the fact that the drug does not work as it should, and the side effects of the drug are intensified. The furanocoumarin compounds in grapefruit block the CYP3A4 enzymes responsible for breaking down estrogens. When grapefruit is consumed with OCs, blood estrogen levels can rise, leading to the risk of new or worse side effects such as nausea, breast tenderness, and uterine bleeding.

One study found that grapefruit juice did significantly increase peak blood levels of 17 alpha-ethinyl estradiol (up to 137%).

Grapefruit can negatively interact not only with oral contraceptives, but also with other medications:

fexofenadine (fexofenadine, Allegra), which is used to treat allergies;
buspirone (Buspar) and sertraline (Zoloft) - for the treatment of depression and anxiety;
sildenafil (Viagra) - male drug for the treatment of erectile dysfunction;
nifedipine (Procardia), nimodipine (Nimotop), and nisoldipine (Sular), which are used to treat high blood pressure;
atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor) - to treat high cholesterol;
saquinavir (Invirase), which is used to treat HIV infection
erythromycin, primaquine and quinine, which are used to treat infections;
amiodarone (Cordarone), which is used to treat irregular heart rhythms
cyclosporine and tacrolimus (Prograf) - used to prevent rejection in organ transplantation.

In addition to grapefruit, Seville oranges (they are often used in marmalade), pomelo, lime, tanghelo, or tangelo (tangerine crossed with grapefruit) may not work well with oral contraceptives.

CYP450 enzymes found in the intestines and liver can remain blocked after eating grapefruit for up to 24 hours or longer. Therefore, even eating fruit or drinking grapefruit juice separately from OK (for example, after a few hours) can still lead to higher estrogen levels. Daily use of grapefruit can have significant, unpredictable effects. Even medications that are taken only once a day can have side effects due to the influence of grapefruit enzymes.

If your drug is not compatible with grapefruit, it is better not to consume this product at all - neither in the form of juice, nor in the form of fruit.

Most other fruits and foods, including orange and cranberry juice, can be eaten and drunk while on the COC. They do not interact with hormone pills.

Other side effects of grapefruit

The combination of estrogen with a lot of grapefruit in rare cases can lead to more serious side effects. So, there is a case when a woman who took COCs (drospirenone and ethinyl estradiol) included grapefruit in her daily weight loss diet. After three days of this diet (about one grapefruit every morning), she developed acute venous thrombosis (a blood clot in a deep vein in the leg). Doctors attributed this in part to the interaction of grapefruit with birth control pills.

In addition, grapefruit can influence the level of estrogen in the blood of a woman, even if she does not take OC. Eight hours after consuming the fruit, estrone-3-sulfate rises 26% from baseline.

HERBAL MEDICINAL SUPPLEMENTS WHEN TAKING OK

Some dietary supplements and herbal preparations also do not work well with birth control pills.

St. John's wort

Some people use it to treat mild to moderate depression and sleep disorders. The study shows that women who took birth control pills and St. John's wort at the same time had higher rates of breakthrough bleeding. This herb can disrupt the metabolism of estrogen from pills by affecting liver enzymes.

Saw palmetto

Sometimes girls drink this herb to stop hair loss and reduce hirsutism. It is not recommended to combine with OK.

Lucerne (Alfalfa)

Used for kidney and bladder problems. Before taking it is necessary to consult a doctor.

Garlic

Garlic tablets sometimes help lower blood pressure, high cholesterol, and are also taken for other heart and blood disorders. Before taking it together with OK, you need to consult a doctor.

Flaxseed is used for digestive problems (severe constipation, irritable bowel syndrome). When taken regularly in large amounts, flax can also affect hormone levels.

Other natural remedies that can potentially affect hormones (such as peppermint, etc.) can only be combined with OCs after consulting a doctor.

A bacterial infection while taking birth control can make some women feel a little anxious. This is because you may have heard about the ability of antibiotics to reduce the effect of hormonal oral contraceptives. This is primarily due to the increased metabolism of estrogen in the liver, as a result of which it may not be enough to prevent pregnancy.

But in fact, not everything is so scary, and very few antibacterial drugs can lead to this. But there are a number of other medications that can also increase your chances of getting pregnant by reducing the effect of birth control pills.

Is it true that antibiotics make birth control pills less effective?

There is a lot of information that antibiotics reduce the effectiveness of oral contraceptives. This is also usually warned about in the instructions for the drugs themselves (contraceptives and antibiotics). In fact, the manufacturers are simply reinsured or based on older research.

Almost all of the antibiotics do not interfere with contraception. It is now believed that the only * types of drugs in this group that interact with hormonal contraception and make it less effective are antibiotics like rifampicin. They can increase the production of enzymes in the liver, which increase the breakdown of estrogen from the pills, and thereby reduce their levels in the body and the effectiveness of the contraceptive itself. This can lead to unwanted pregnancy.

* - In addition, there is also an antibiotic called griseofulvin, the mechanism of influence of which on the effectiveness of contraceptive pills is not fully understood. But this is an antifungal drug, therefore, it is described at the end of the article along with other drugs.

Simply put, only antibiotics such as rifampicin, rifabutin... And also an antifungal antibiotic griseofulvin... The rest are not.

List of antibiotics that will not affect hormonal contraceptive drugs(although the instructions for the drugs may indicate):

Tetracycline: Used for acne, tooth infections, Lyme disease
Ciprofloxacin: urinary tract infections, some ear infections, pneumonia
Penicillin: strep throat, tooth infections, upper respiratory infections, ear infections
Flagyl (metronidazole): vaginal infections, some infectious diarrhea
Others such as doxycycline and ampicillin.

Scientists have investigated the simultaneous use of these antibiotics and contraceptives, as a result, it was found that they do not change the effectiveness of contraception.

There are only a few rare situations where an antibiotic actually interferes with your contraceptive method. If you have tuberculosis or meningitis and are taking rifampicin or rifabutin, it may reduce the effectiveness of birth control pills, patches, and rings. You need to tell your doctor if you are using oral contraceptives and have been prescribed rifampicin. You will likely be taking an antibiotic for about 6-9 months to fight TB, and your doctor may suggest changing it. If you decide to continue using your current drugs, it is important to use a different form of contraception while you are taking it.

After you finish taking these antibiotics, you will need to continue to use alternative methods of contraception besides pills for another 28 days.

The reason women should be careful with certain medications when it comes to birth control is because some of them affect the production and metabolism of hormones in the body. Birth control pills are designed to prevent ovulation by altering or stopping the hormonal process. Rifampicin is a drug that changes the metabolism of hormones, and due to its intake, ovulation can occur and, therefore, it will be possible to become pregnant.

While most antibiotics do not interfere with the anti-pregnancy medication, it will always be more effective to use additional protection. If you would like more information about these products, just ask your doctor or pharmacist.

Why then do manufacturers sometimes warn about other antibiotics in the instructions?

As mentioned above, only a very small amount of antibacterial drugs can actually reduce the effect of hormonal contraceptives by increasing the production of enzymes in the liver that break down estrogens. These are antibiotics like rifampicin or rifabutin. But you can also sometimes find in the instructions for the contraceptive pill a warning about other more common antibiotics, for example, penicillins and tetracycline. The same can be said for the antibacterial drug itself. This information differs from the evidence-based advice used by healthcare professionals today.

Most likely, manufacturers are reinsured in this way. Indeed, in addition to enhancing the production of estrogen in the liver, in theory, antibiotics can kill bacteria that convert inactive chemicals into active estrogen, and therefore can interfere with the effectiveness of birth control pills. While it hasn't been proven that unwanted pregnancies can occur this way, drug manufacturers warn that antibiotics can reduce the effectiveness of birth control pills.

Other medications that may affect hormonal medications

If you get sick and need to see your doctor for medication, be sure to tell him everything you are taking, including birth control pills. The professional needs to know about any medications, herbal remedies, and prescription drugs. When you get a prescription for a new medicine, ask your doctor or pharmacist at your pharmacy if there are any drug interactions with contraceptives to be safe.

Some of the drugs that can interfere with hormonal contraception, including pills, are:

Griseofulvin

Griseofulvin is an oral antifungal antibiotic that is used to treat fungal infections of the skin, body, hair / beard, or nails. The reason this medication interacts with birth control pills is unknown, but the consequences can be serious. Concomitant use can not only weaken the effect of contraceptive pills and lead to pregnancy, but also cause breakthrough bleeding and an irregular menstrual cycle. When prescribing these medicines together, your doctor may need to change the dose of the birth control pill or replace it with another form of contraception. The effects may last up to one month after you stop taking griseofulvin.

St. John's wort medicines

This herb is taken for depression or anxiety, and studies have shown that it can reduce the levels of hormones the body receives from the pill. This can cause spotting and / or ovulation. It is very important to use a back-up method of contraception if you are using this method.

Epileptic drugs / mood stabilizers

Drugs such as Tegretol, Phenytoin, Primidone, Topamax, and Lamotrigine can reduce the effectiveness of contraception. In addition, hormones can reduce the effectiveness of these drugs, and you may be at increased risk of seizures or mania. Although, according to a 2010 study, the effect of oral contraceptives on seizures is controversial.

Make sure you discuss the use of epilepsy medications and contraceptives with your doctor to avoid drug interactions. The doctor will need to know that you are using hormones so that he can control the dose of the drug to prevent seizures.

Antiviral / HIV drugs

HIV medications can make the pills less effective in preventing unwanted pregnancies. These include Darunavir, Nevirapine, Lopinavir, Tipranavir, Fosamprenavir, and Nelfinavir. There are other HIV medications that will not interfere with the effect of the birth control pill. Make sure you use a back-up birth control method during your HIV treatment.

How to improve the effectiveness of contraceptives?

When you get a prescription for antibiotics, ask your pharmacist at your pharmacy if there are any medications that make birth control pills less effective.
Use a different method of contraception when taking antibiotics. If you use a spermicide and a membrane, the efficiency is almost 100%.
Take your birth control pill at the same time every day. Follow your doctor's advice.
Do not skip pills and follow the directions to “catch up” with the missed dose.
If your method of contraception is an IUD, make sure you get it checked every month. If you cannot find it, you need to use another form of contraception and see your doctor as soon as possible.
If you have had unprotected intercourse, you can contact your doctor or pharmacy within 72 hours for

Many of them are enzyme inducers, which leads to an increase in the number of enzymes. The more enzymes that destroy the contraceptive, the faster its activity in the blood will decrease.

Many women have had an unplanned pregnancy while taking birth control and antibiotics. It turned out that the latter change the mechanism of action of many drugs and make birth control pills less effective.

If you are taking antibiotics and contraception together, you should insure yourself with condoms or other methods (suppositories, interrupted intercourse, spermicidal ointments, etc.). Be sure to pay attention to the section of the instructions of your medication "interaction with other medicinal substances." OK, you cannot drink tea, because it contains tannin, which forms an indigestible compound with contraceptives. With the "support" of the antibiotic, it will further reduce the effectiveness of the drug.

This natural remedy 100% relieves pain during menstruation! Do you guess what it is - you will get rid of it forever!

Be aware that high doses of vitamin C can absorb estrogen. Therefore, do not drink ascorbic acid with preservatives. The same effect is given by paracetamol and many anticonvulsants. The break between such drugs should be at least two hours.

Contraceptive effectiveness can be reduced not only by co-administration of birth control pills and antibiotics. Antidepressants, paracetamol, herbal preparations containing St. John's wort, many antifungal and chromium-containing drugs, grapefruit juice and citrus itself can reduce or nullify the effect of the contraceptive.

Each means of preventing pregnancy has its own formula of reliability. As a rule, the reliability of the formula is very high. But if you add some random term to it, then the effect can decrease many times. The reliability of hormonal contraceptives is 90-99%, the reliability of the combination of antibiotics and contraceptives is%.

If you had to take antibiotics and birth control pills, then, despite the unsuccessful combination of drugs, it is recommended to finish the pills to the end of the package. During this cycle, it is advisable to additionally protect yourself with a condom or other barrier means.

Antibiotics and oral contraceptives can be a dangerous combination. The simultaneous use of antibiotics from the group of cyclosporins (Rifampicin, Griseofulfin, Rifabutin, Tetracycline) and Postinor increases the harmful effect on the body of both drugs. The liver, biliary tract and the reproductive system of a woman are especially affected. In addition to reducing the contraceptive effect, you run the risk of serious complications, especially if you already have health problems.

Now you know what reduces the effectiveness of hormonal contraception, and you can avoid unwanted pregnancy. Use knowledge in practice and be happy!

This remedy relieved all Chinese women from menstrual cramps! It will help you too! You glue on the groin and forget about the pain!

Hormones and antibiotics

Jenna Barclay is my favorite nutritionist, whose opinion on healthy eating I completely trust. In this article, she shares her views on the hormones and antibiotics we take in our daily lives and the effects they have.

The most important thing is to remember that the body itself knows how to maintain itself in optimal condition and how to heal itself if necessary. When we are not feeling our best, it is a sign that we are not giving the body the ingredients it needs to function properly.

Most often, we ourselves disrupt the functioning of the body by eating anti-nutritive foods that remove nutrients and energy from the body. As a result, we feel worse and worse. If we consume large amounts of these substances, then we upset the balance in the body, and he has to work hard to maintain this balance. The more energy we expend trying to remove anti-nutrients from the body, the further we move away from having a healthy body.

Hormones and antibiotics are two of the best known anti-nutrients, and they are more common than we think, such as birth control pills and antibiotics for infections. They are quick fixes for problems, so there is always a temptation to accept them, but in general they are only short-term help. There is not enough research on the long-term effects of these pills, and they have been linked to cancer and other chronic diseases. When taking contraceptives, the body often loses its ability to regulate the menstrual cycle, and sometimes you have to wait for months when you stop taking the next cycle. It's the same with antibiotics - they can make you feel better, but they interact with the body's immune system and increase the chances of getting sick again.

In addition, ingestion of these chemicals compromises our immunity, internal balance, metabolism, and the body's ability to burn fat. You may avoid illness, but you will suffer from mood swings and become prone to gaining weight.

But this is only half the trouble. Even if we do not take any of the above, there is a chance that these elements will still enter our body through food. Most animals raised and fed for slaughter or for milk and eggs are injected with steroids and hormones in order to accelerate growth. And then they are fed with antibiotics so that they do not catch any disease from other animals.

The only viable way to tackle all of our problems is through a holistic approach. Eat fresh, unprocessed foods to help your body heal itself. Opt for organic animal products to avoid taking unnecessary hormones and antibiotics through food.

Hormones and antibiotics

Working with patients. I periodically face the fact that they are afraid to take and use drugs containing antibacterial agents and a hormonal component. I'll start with a simple one - Antibiotics. Are they harmful? If they are wisely prescribed by a doctor, then the risk of their consequences is minimized, but if you refuse to take them, it can lead to disastrous consequences. The presence of a bacterial infection is one of the indications for the appointment of antibiotics. In case of refusal to accept, in turn, the process can turn into bacteremia and even sepsis. Moreover, by prescribing a bacteriological examination, the doctor may prescribe an antibiotic even before the results are obtained, if he considers the condition to be serious or life-threatening. Another indication for the appointment of antibacterial drugs: any operation, be it an appendix or a tooth extraction. For what? With any surgical intervention, there is a risk of developing suppurative processes and in order to avoid them, these drugs are needed.

Now let's talk about hormones that patients are so afraid of. Yes, indeed, prescribing hormonal drugs on your own can cause trouble, but if a doctor does it, then there is a need for it. So, external agents: ointments, creams, gels containing cotricosteroids. Usually they are prescribed for severe allergic reactions manifested on the skin, eczema, and other dermatoses occurring with severe itching. Today, many combination drugs have appeared due to this, the range of their use has expanded much. Usually, the appointment of external agents is combined with drugs inside of a non-hormonal origin, but in especially severe cases, drugs of the adrenal cortex are also prescribed inside and refusal to take these drugs can lead to serious consequences. A simple example: a patient was admitted to the hospital with single vesicular rashes on the trunk. On examination, she was diagnosed with pemphigus vulgaris, the prognosis for this disease is not favorable, the state of stability is maintained with the help of hormonal therapy for the duration of life. The task of the doctor is to select adequate doses and minimize side effects. Naturally, this was announced to the patient. Despite the fact that I am not familiar with traditional practices, I never undertake to treat patients with such problems with the help of them, but people who are not quite versed in medicine especially like to do this. So there was such a grief for a homeopath. Gave herbs and promised that everything would go away and you can refuse hormones - the result? A week later, the patient was taken to the same hospital, but already her body was completely covered with wounds, blisters, and more like a living wound, she could not help singing, not sit and suffered from pain throughout her body, her condition was extremely difficult, it was 70% of the body was affected and initially, it was not clear whether the doctors would cope. Yes, this story ended more or less happily, but the doses that were now prescribed turned out to be several times higher than the initial ones, since at that moment it was already a question of saving the patient's life. About ointments. There are certain schemes of how to properly avoid preparatory drugs in order not to get the so-called "Withdrawal Syndrome". Hormone therapy is carried out not only in dermatovenerology, but it is also actively used in other branches of medicine. So, for example, gynecology is a violation of the hormonal background. With a slight change in the indicators of sex hormones, you can try to do without it, but if the hormone readings in organicism are significantly changed, then you cannot do without hormonal correction, the same is true in the absence of ovulation. By the way, the last generation hormonal contraceptives are the most effective and practically give a 100% guarantee, not only do they not change the hormonal background, but also help in some cases in solving infertility problems. Endocrinology. Now, unfortunately, a lot of people have appeared with thyroid diseases, and if they are also accompanied by a violation of the hormonal background, then you cannot do without hormones. Namely, a lack or excess of certain thyroid hormones can lead to fatigue, irritability, pressure fluctuations, changes in the heart rhythm, even pain in the heart and many other symptoms. With adequate hormone therapy, these symptoms can go away. But lastly: hormones cannot be dispensed with in such severe conditions as toxic shock, Quincke's edema and convulsive conditions, but naturally, the doctor should prescribe all these drugs, since he prescribes certain drugs to make a treatment regimen so that the maximum avoid the side effects of these drugs. Dermatovenereologist Ovsienko Elena Yurievna.

About antibiotics and hormones

Sorry to be late, but better late than never. You know, when you do not "burn" in any place, you postpone everything and postpone a long-conceived letter. And I wanted to ask you not a specific question-diagnosis, but so - reasoning on the topic.

I am interested in such things as the attitude of people and DOCTORS to antibiotics and hormones. Why do doctors love these drugs, while ordinary people are afraid of them like plague? I do not understand this. After all, how many diseases were started precisely due to our panic fear of AB and hormones? And how many nasty things were cured thanks to ONLY AB or hormones. I would very much like you to express your attitude on this issue. Because, for example, I don’t believe when my mother writes: “Oh, what a horror! Your child is so young and has already been prescribed macrofan (penicillin, erythromycin, etc.). Your doctor is a donkey, chase him in the neck and do not do such nonsense. For 10 years as a child, I have NEVER treated AB pneumonia, although they prescribed it, and nothing, everything is fine, the child is alive and well. “I don’t believe in such things, for the life of me. And phrases annoy me - your doctor is a fool, he does not know what he is prescribing.

If you do not trust your doctor - why go to him; if you trust, why do you ask and listen to people who do not have, unlike a doctor

a) honey. education;

b) sufficient knowledge and

c) the experience of a practicing doctor.

I would very much like to understand the meaning of such common phrases as: "irrational use of AB", "untimely assignment of AB", "excessive assignment of AB", etc. etc. After all, a doctor, prescribing, for example, with otitis media of the corresponding series, knows that it will concentrate in the Eustachian tube, and this drug will kill the causative agents of otitis media, for example. I understand that medicine is not mathematics and science is rather approximate, but nevertheless we do not swallow some new drugs that have not passed clinical trials, but well-known drugs that are well-studied, as usual, and have positive reviews, etc. etc. In what then can be expressed "untimely", "irrationality", "redundancy"? And under what other things being equal, it can “shoot”?

All this, in principle, applies to hormones. Why torture a child and yourself, curing atopy not with Advantan, for example, but raising it. oil, cat. and does not help (this is all for an example). Isn't it easier to smear the rash with Advantan a couple of times in order to prevent the addition of a secondary infection and calmly look for the cause of the allergy than to shout: “Help! You will heal the child ”and throw all your strength into an ineffective struggle with the manifestations of the disease, and not with its causes.

And I also “like” phrases like: “Do not put your child on hormones and antihistamines from an early age, but go straight to a homeopathic wizard and swallow balls of strange origin all your life. He will provide you with practically immortality. " Sorry for the confusion. The child is asleep, I am in a hurry to write. Otherwise, he will wake up, let's go outside again (Lord, I'll probably live there soon!).

Best regards, Olga

First, about antibiotics. The fundamental essence of the issue is that any medicine has its own clear indications for use. There are indications - what is there to be afraid or not to be afraid of - common sense tells what to apply.

My daily practice just does not confirm your statement that ordinary people are afraid of antibiotics like fire. Moreover, antibiotics are often used without a doctor, by these very ordinary people. And in a situation where the doctor does not prescribe, these same ordinary people are very often indignant. For me, as a real practicing doctor, the use of antibiotics for the slightest sneeze is a very big problem. And if on one side of the scale we put “how many diseases were started precisely because of our panic fear of AB”, and on the other “how many diseases became chronic, how many people could not be saved due to premature or unjustified prescribing of AB” - so for me the second cup will be more weighty.

Who will argue about whether it is necessary to prescribe antibiotics for pneumonia, meningitis, scarlet fever, sore throat. But with ARVI? For acute bronchitis, which is almost always viral? Quite often, the prescribed antibiotic means not antibiotic therapy, but psychotherapy of relatives and insurance for the doctor: relatives calm down knowing that they are using an allegedly effective medicine, and the doctor is sure that if complications arise, he will not be to blame - he did everything, that he could and prescribed antibiotics. Illustration. The child fell ill on Sunday. Snot and temperature 39. On Monday they began to swallow ampicillin. On Wednesday, no better - temperature 38. Cefazolin was injected. On Saturday, no better - he coughs, the temperature rises. X-rays were taken. Revealed pneumonia. Now we need to heal. The question is - what? For this is not just pneumonia, but pneumonia caused by bacteria that survived after ampicillin and cefazolin. Those. if they didn’t give anything (because antibiotics were not needed - an acute onset with snot - an obvious ARVI), they could have drunk the syrup of the same ampicillin from Saturday and cured pneumonia. Now it turns out that it is necessary to buy something more expensive and more serious. And there is no more money for this "more serious". I have to go to the hospital, etc. etc. During my work in the children's intensive care unit, the worst thing was - when such a child came in - who was first treated by mom-dad, then the district doctor, then in the regional hospital, and then they decided to send it to the regional hospital - and there was nothing to treat - they had already tried everything , and it ended. The otitis media you mentioned is perfectly treated with the popular (cheap, non-toxic, effective) antibiotic amoxicillin (syn. Flemoxin, ospamox). But otitis media is almost always a complication of ARVI. Will amoxicillin be effective if it is prescribed before otitis media, at the very beginning of ARVI? Of course it won't. The main misconception is that people are sure: as long as amoxicillin treats otitis media and pneumonia, then if it is prescribed at the very beginning, then there will be no otitis media or pneumonia! And this is far from the case. The cause of otitis media is a violation of ventilation of the ear cavity due to blockage of the Eustachian tube. The cause of pneumonia is a violation of ventilation of the lung area due to blockage of the bronchi with viscous sputum. We cannot kill all bacteria at once. And there are a great many of these bacteria in the nasopharynx. We'll prescribe amoxicillin before we get pneumonia or otitis media caused by bacteria that will survive. Amoxicillin does not work on staphylococcus aureus. What do you think, is it good as a result of such "timely antibiotic therapy" to get not just pneumonia, but staphylococcal pneumonia, which is more difficult to treat and gives complications many times more often? The question is rhetorical. But not to prescribe an antibiotic does not mean “not to cure”, because treatment is completely different and completely specific actions, they are described in the chapters on otitis media and pneumonia, I will not dwell on this. "

I would very much like to understand the meanings of such common phrases as: "irrational use of AB", "untimely assignment of AB", "excessive assignment of AB" "irrational use of AB". Rationality in antibiotic therapy is that there are recommended (optimal) treatment regimens for diseases in which the pathogen is known. Scarlet fever - penicillin, whooping cough - erythromycin, typhoid fever - chloramphenicol, etc. There are recommendations on the empirical choice of a drug before it is possible to isolate the pathogen (if it will be isolated at all). So when treating pneumonia, the age of the child, the place where the pneumonia arose, is taken into account, and theoretically the doctor knows that some microbes cause pneumonia in a newborn, and others in a three-year-old. Home pneumonia is usually caused by pneumococcus, hospital pneumonia by other bacteria. Deviation from scientifically based schemes is a sign of irrationality. It is not rational to treat scarlet fever or home pneumonia with rovamycin or claforan - but with penicillin it is quite rational. One of the manifestations of irrationality (extreme) is the wrong choice - you cannot treat home pneumonia with gentamicin, because it does not act on pneumococcus. It is wrong to treat whooping cough with penicillin, because penicillin does not work on whooping cough. It is not correct to treat measles, rubella, mumps, SARS, etc. antibiotics, because these are viral infections, antibiotics cannot help at all. "Untimely appointment of AB" A specific bacterial infection was not recognized in time, so it was not prescribed. But at this point, everything is not so simple and no one in their right mind will pull up with antibiotics with obvious signs of a bacterial infection - sore throat, meningitis, scarlet fever, etc. But it is the threat of being accused of untimely prescription that leads to the fact that antibiotics are much more often prescribed prematurely or not at all on purpose. 3rd day of ARVI. Child 5 months. On examination - a cry to the whole house. Can the doctor, listening to the screaming child, be sure that the lungs are clear? Can not. And in a couple of days, an ambulance will arrive at night, take you to the hospital, they will take an X-ray and so gently and collegially notice that you have brought the child, how difficult it will be to save you, if only 2 days ago. A wonderful way to immediately dot the "and" - in any case, we are not to blame, your doctor did not recognize it in time. And no one will prove that there was no pneumonia then, did not appoint - it is to blame. And they will appoint everyone. "Excessive prescription of AB" A particular case of irrationality - injections, instead of sweet syrup, three drugs instead of one, ceftriaxone, instead of ampicillin, etc. The essence. Antibiotics are serious, highly effective medicines. When on business, yes skillfully. If not on the case, then: - the risk of allergies, the risk of complications of antibiotic therapy (dysbacteriosis, specific complications - hearing loss when using gentamicin, etc.), the risk of the emergence of resistant bacteria - is relevant both for a particular patient and for society as a whole. Each of us has a chance to get seriously ill - to get into an accident, get pneumonia and end up in the hospital. And it will be very great if at this moment we do not even think about the fact that we are allergic to the penicillin group, which (allergy, of course) we have earned out of the blue, swallowing ampicillin with a cold. For me personally, the concepts of "pneumonia" and "resistant bacteria" are not just empty words. At the age of 29, I myself developed lobar pneumonia in my native intensive care unit. And when the best laboratory in the city isolated streptococcus, staphylococcus and E. coli from my blood, which are resistant to almost everything, then I, as a doctor, was perfectly aware of my prospects. And when I now look at the X-rays of my own lungs taken then, I still do not fully understand why, after two months of half-life, God still allowed me to remain in this world. And hormones in the treatment of allergic dermatitis are ostrich therapy. Influencing the effect, without understanding the cause.

"Isn't it easier to smear rashes with Advantan a couple of times in order to prevent the addition of a secondary infection and calmly look for the cause of the allergy." Nobody bothers to look for these reasons both before Advantan, and during and after. Only when it becomes easier does the search intensity for some reason decrease. And you cannot even imagine what kind of secondary infection develops precisely against the background of hormones, and what terrible microbes cause it. Therefore, there are clear indications for hormones - intense itching, a rapid increase in allergy manifestations, etc. And feeding with oranges and at the same time smearing your cheeks with Advantan - do you think this does not happen? What a calm search for reasons there. Summary: all the "folk thoughts" you quoted are just oral folk art. I generally cannot understand what a certain neighbor or acquaintance has the right to comment on the treatment of your child and give advice on this matter. This is your child, and it would be just great if your child had a doctor who is not afraid of the mother of his patient, treats him as he would treat his child, and he would treat his rationally. And this is the main thing that I would like to wish you. All the best. Komarovsky Evgeny Olegovich

Hello Evgeny Olegovich!

Thank you very much for your reply. You know, in my opinion, people are divided into two camps - those who consider antibiotics a panacea for all ills and drink them indiscriminately (unfortunately, there are doctors in this group) and those who are afraid of them like fire and under no circumstances they are trying to delay further and further with the use of AB. That's about the second I asked. The first - God bless them, everything is clear here and the logic (is it?), In principle, is quite clear. But the latter surprise me terribly. Because, after all, there are people who treat pneumonia with a cold shower, and with otitis media, clog their ears with geranium leaves. It is in this case that I would like to know where the legs grow from, because all sorts of horror stories about AB are spread by doctors and paramedical figures, because, for example, such information is not available to me due to my prof. unsuitability in this area and I, accordingly, cannot judge this, much less disseminate any information.

“Who will argue about whether it is necessary to prescribe antibiotics for pneumonia, meningitis, scarlet fever, sore throat. But with ARVI? For acute bronchitis, which is almost always viral? Quite often, the prescribed antibiotic means not antibiotic therapy, but psychotherapy of relatives and insurance for the doctor: relatives calm down knowing that they are using an allegedly effective medicine, and the doctor is sure that if complications arise, he will not be to blame - he did everything, what he could and prescribed antibiotics. " This question has been worrying me for a long time. It is no secret that many doctors prescribe AB for ARVI precisely for the purpose of PREVENTING bacterial complications. I've always thought that problems need to be dealt with as they come, but no. The last time, to my question: “How can we not get otitis media, pneumonia, etc. again?”, The doctor replied: “If the temperature is above 38 degrees. will last more than three days, then you need to start drinking AB ". This jarred me a little, but I did not argue with him. Although, the doctor is quite respected, young, progressive and far from being a fool.

“The rationality in antibiotic therapy is that there are recommended (optimal) treatment regimens for diseases in which the pathogen is known. Scarlet fever - penicillin, whooping cough - erythromycin, typhoid fever - chloramphenicol, etc. " Here, here, and this question worried me for a long time. Because on the example of our uch. the doctor can doubt the presence of this very "empirical choice", tk. I always get the same answer to any question about antibiotic therapy: “We will drink sumamed”. The first time I managed to avoid this, they were perfectly cured with Rulid, in the second ARVI we were also threatened with drinking sumamed after three days (for what such indications, on what grounds, it is not clear). You see, my sobs about this - this doctor said so, and this commercial in no way are accusatory in relation to specific doctors, tk. and one and the second I respect and I like both of them. Apparently, they complement each other in my particular case. But the point is that these stories of mine are not something special. These are ordinary everyday life for many, many doctors and parents in the territory of the former Sov. Union. And the saddest thing is that it is almost impossible for non-medical parents to get reliable, competent and well-presented information about AB and their use. And about hormones. I, in principle, did not mean hormone therapy for atopy, etc. specifically. I am generally interested in this topic. Hormones are used to treat a lot of diseases. After all, it's not a secret for anyone (maybe I'm wrong) that at the moment the most effective anti-inflammatory drugs are. hormonal ointments. Is that so? And after all, there are testimonies when one cannot do without the notorious Advantan. But they don’t give it. We, for example, had nothing super-dangerous in this sense (I will spit three times). But I saw on the street, on children. creepy faces of small (usually up to 1.5 years) children, their hands, ears. It was impossible to look at them without a shudder - one continuous crust of purple, weeping or, on the contrary, dry. To the question “how do you cope with this”, I almost always received the answer “We bathe in a chamomile and a series”. But you see - it does not help, you see that it only gets worse - no, they are intimidated by hormones thanks to or uch. doctor or all sorts of publications and programs. I’m not saying that we all need to be treated with AB and hormones, but that it would be nice to be more relaxed about these methods. Patients should not draw an enemy in every tube, or vice versa, should not swallow / smear indiscriminately, and doctors and officials would give the population calm, balanced information without horror films and embellishments. The summary of my message is as follows. Last time I simply did not formulate my question, I blurred again. And the essence of my question was the following: is antibiotic and hormone therapy really so terrible, terrible and harmful to the human body, as some patients and even doctors believe. Is it really that such "bombing" is used to treat a patient almost on his deathbed, and before that, you can do with easier means? Although, in principle, I received the answer - diagnostics is probably the most sore spot in our medicine. I'm right? Thank you for your attention.

Best regards, Olga

Let's isolate the main thing: "Is antibiotic and hormone therapy really so terrible, terrible and harmful to the human body, as some patients and even doctors believe?" Is it really that such "bombing" is used to treat a patient almost on his deathbed, and before that, you can do with easier means? "

And to summarize: not terrible, if used correctly and efficiently, it is very effective and practically safe. The hardest part is the aforementioned "literate and rational". But this is a separate topic. And there are really a lot of fears that are unnecessary. A typical example is the attitude of the “broad masses” to the same hormonal contraceptives - how can you convince people that taking pills for 10 years is less harmful than having one abortion? It is very difficult to deal with these rumors and fears in our country, first of all, because everyone considers himself a specialist, but this is half the trouble. And the main problem is that many people consider themselves entitled to give valuable instructions to those around them - neighbors, acquaintances and passers-by. And it is almost impossible to fight this.

All the best. Komarovsky Evgeny Olegovich

Compatibility of antibiotic and hormonal pills.

With prolonged ARVI, the therapist prescribed me to take Augmentin. At the same time being examined by a gynecologist, I was diagnosed with an endometriotic cyst of the right ovary, and hospitalization was prescribed next month for laparoscopy. At the same time, from the 1st day of menstruation, Regulon was appointed. Can I start using Regulon in parallel with Augmentin? Are Augmentin and Regulon compatible?

Good afternoon, Ekaterina! Yes, you can take the drugs together, but in some cases antibiotics can reduce the contraceptive effect and the therapeutic effect of Regulon. Therefore, during the intake of the medication, it is better to additionally use other methods of protection. But as a stage before the operative intervention, Regulon can be drunk, regardless of taking Augmentin.

Antibiotics have been found to reduce the effectiveness of birth control pills. Some women became pregnant because they were sick and were taking antibiotics at the same time they were taking the pills, because they did not understand that this could change the way the pills worked.

Antibiotics for Hormonal Contraception: Be Vigilant

The birth control pill is considered one of the most effective types of contraception. When they first appeared in the 1960s, they changed the lives of women who could now, for the first time in history, have sex just for pleasure, without facing a high risk of pregnancy. Women began to choose their family size. Fewer children per woman means she has more career opportunities. But when using this contraceptive, you should remember about some features.

Why do antibiotics affect birth control pills?

Antibiotics alter the intestinal flora and affect the body's ability to metabolize hormones. More of the active ingredient is lost during bowel movements and breakthrough bleeding and pregnancy can occur.

Examples of antibiotics that can affect tablets include amoxicillin, ampicillin, erythromycin, and tetracycline. Other antibiotics, which are also enzyme inducers such as rifampicin and rifabutin, are powerful and render the pill ineffective. These types of medicines can increase the amount of enzymes in the body. They are known as enzyme-inducing, and can interfere with hormonal contraception. The enzymes in the body do not return to their normal balance for several weeks after taking this type of medication, so doctors advise using other methods of contraception.

Enzymes are proteins that control chemical reactions in the body and they can speed up the processing of tablet ingredients. The less active components there will be in your blood. This is why pregnancy can occur if no other method of contraception is used.

What else can reduce the effectiveness of the pills?

Anticonvulsants such as phenytoin and carbamazepine.
HIV medications such as Norvir.
Taking ulipristal acetate tablets the next morning.
Taking herbal medicines, for example, for depression. There have been several reports of pregnancy in women taking St. John's wort.
Diarrhea and / or vomiting

If you have been taking an enzyme-inducing antibiotic, alternatives, a non-hormonal method, are needed four to eight weeks after you stop treatment. Apart from those mentioned above, all other antibiotics are non-enzyme-inducing.

Do antibiotics reduce the effect of birth control? This question has puzzled many women. The latest data from medical research gives the unequivocal answer - YES. Antibiotics can alter the intestinal flora and reduce the absorption of hormones. Many of them are enzyme inducers, which leads to an increase in the number of enzymes. The more enzymes that destroy the contraceptive, the faster its activity in the blood will decrease.

Contraceptive effectiveness can be reduced not only by co-administration of birth control pills and antibiotics. Antidepressants, paracetamol, herbal preparations containing St. John's wort, many antifungal and chromium-containing drugs, grapefruit juice and citrus itself can reduce or nullify the effect of the contraceptive.

Now you know what reduces the effectiveness of hormonal contraception, and you can avoid unwanted pregnancy. Use knowledge in practice and be happy!