Depo and Antibiotics

iVillage Member
Registered: 09-14-2004
Depo and Antibiotics
9
Tue, 11-09-2004 - 4:39pm
I can`t seem to find an older post by one of the CL's that listed a site that said that antibiotics may affect the effectiveness of Depo. I was wondering if someone could perhaps pull it up again?

In a few days, I`ll probably be starting another round of antibiotics - this time Ketek - for a very stubborn, chronic sinus infection. It`s a different kind of antibiotic than like Amoxicillen or Augementin and I`m concerned about it affecting Depo. I can`t seem to find much information about Ketek since it`s a relatively new antibiotic (only on the market in the U.S. for about 2 years). Any information?

Thanks,

Lena

iVillage Member
Registered: 12-30-2003
Tue, 11-09-2004 - 6:16pm
Hi Lena,

The Eckerd Drug Advisor is the one I usually use: http://www2.eckerd.com/content.asp?content=pharmacy%2Fdrugadvisor&cookie%5Ftest=1 This is what Eckerd says about ‘Depo-Provera’

“What drug(s) may interact with medroxyprogesterone?

•antibiotics or medicines for infections, especially rifampin, rifabutin, rifapentine, and griseofulvin

•aprepitant, a medicine used for chemotherapy-induced náusea and vomiting

•barbiturate medicines such as phenobarbital, may be used to induce sleep or to treat seizures

•bosentan

•medications for treating seizures (convulsions) such as carbamazepine, phenytoin, or primidone

•modafinil

•St. John's wort

•troglitazone or pioglitazone”

Another good location is Drugs.com’s Drug interaction checker: http://www.drugs.com/drug_interactions.html

You might also want to ask both your doctor and pharmacist for their opinions about possible interaction between Ketek (Telithromycin) and Depo.

Let us know what they say and how you’re doing, ok?

Good luck,

      Jill

    

iVillage Member
Registered: 03-19-2003
Wed, 11-10-2004 - 7:20am
I'd absolutely check with the pharmacist on this one. I had read somewhere that antibiotics didn't affect Depo (I want to say it was the prescribing information, but don't quote me), so especially in this case you'll want to double-check with as many professionals as possible! ;)

Hope you get to feeling better...

Judie
Co-cl for Birth Control
Judie Cl for Birth Control 
iVillage Member
Registered: 09-14-2004
Thu, 11-11-2004 - 2:52pm
I called the Depo-Provera help line today to ask them about a possible interaction between Ketek and Depo. After getting transferred to about three different places, being told I`d be called back within 30 minutes (ended up being 2 hours), have to wait another 30 minutes after they finally called me back... I finally got an answer.

Uhm, sort of.

I was told by a representative at Pfizer that there was very little information about the effect of Ketek on Depo, but that an interaction had been reported between another method of birth control and Ketek. Well, duh, it`s an antibiotic. She didn`t say what method is was, just that it allowed more of the hormones to be released into the blood stream (from that, I`m assuming it was the ring or the patch, maybe an IUD). So I`m not sure what to do.

If it raises the level of progestins in my blood stream, well, that doesn`t make me more likely to get pregnant. But will is possibly lower the hormones enough during the end of my 3-months, before my shot is due, that I won`t be sufficiently protected against pregnancy?

I guess I shall call my pharmacist, and maybe my doctor back. This is so frustrating! Argh! I imagine I`ll use condoms, just to ease my own mind over this weird situation.

iVillage Member
Registered: 12-30-2003
Thu, 11-11-2004 - 7:39pm
Hi Lena,

Thanks for the update! I think you are right on about calling your pharmacist and the doctor who prescribed Depo for you, to see what they advise. You might also want to see what Aventis, the manufacturer of Ketek has to say. The Ketek site is http://www.ketek.com/KETEK_welcome.html They don’t seem to have a toll-free phone number but you can e-mail them with questions. The contact screen is: http://www.ketek.com/contact_us.html Keep us posted, ok?

Hugs,

      Jill

    

iVillage Member
Registered: 05-11-2004
Thu, 11-11-2004 - 9:36pm
I believe that it's safe to take Ketek and birth control. It's not in the class of the common antibiotics effecting the pill.

Unfortunately, not much research is available on Ketek. It has NOT been available for 2 years, but rather only a couple of months. It's VERY new.

iVillage Member
Registered: 10-04-2003
Thu, 11-11-2004 - 10:04pm
Unfortunately, at some point all antibiotics have potential to decrease the effectiveness of the pill. There are more common antibiotics that are known to decrease, however, the newer antibiotics that have come out, there is argument as to whether the have the same effect or not. When it came down to it, there is still a risk, therefore back up is always a good idea... I was just in this delima, i was told that my antibiotic (which is similar to Ketek) would not effect my pill, however, i called around and got some different opinions from other pharmacists and 3 to 1 recommended backup... I guess you can never be too careful. As to whether or not it affects depo, i am not sure...
iVillage Member
Registered: 09-14-2004
Thu, 11-11-2004 - 11:24pm
As I was prescribed Depo by the local health department, I don`t really have a singular doctor that I can ask, but I will be checking in with the one that has given me Ketek. I will also drop by the Planned Parenthood clinic that gave me my last injection and see what they may have to say. I`m sure that for my trouble, they`ll at least give me the bag full of condoms that they shove at me everytime I come through the door!

I emailed Aventis. Hopefully I`ll get a reply shortly. If everything goes as plans, I`ll be able to start my round of antibiotics on Monday (I`ve been waiting until all of this mess with interactions with Depo is answered for me).

If all else fails, the boyfriend offered to abstain until I either get another Depo shot or begin a new method of birth control in the beginning of January. I`m wary about the fact that if I take Ketek and it causes more progestin to be released into my system that, at some point in time unbeknownst to me, my hormone levels will drop low enough to trigger ovulation. And that would be majorly eek! At least he`s understanding. He did offer to try out the dreaded "C" word, but I`m not sure if I`d be comfortable with that, not knowing if I`m ovulating or not. I mean, chances are that I won`t ovulate for quite a few months, but I just can`t take that chance, you know?

Aaaanyways, I`ll keep you guys update as I find out information! Hopefully I`ll be able to get a straight answer tomorrow.

Lena

iVillage Member
Registered: 09-14-2004
Fri, 11-12-2004 - 3:44pm
Newest news:

Aventis says: There haven`t been ANY tests done with Ketek and birth control, so they don`t really know about Depo with it. And that Pfizer is full of crap for saying that there have been tests. Well, that`s pretty close to what he said. :)

Dr. Gregg says: That he searched an "online, up-to-date medical lexicon" and it said that there were no interactions between Depo and Ketek.

So...yeah. Still confused. sigh.

iVillage Member
Registered: 09-14-2004
Tue, 11-16-2004 - 3:36pm

So, here`s the last rounds of opinions on Depo and Ketek.

My doctor says: There shouldn`t be an iteraction between Depo and Ketek because they operate in completely different areas: while Depo is intramuscular and bypasses the G.I. tract, Ketek does it`s "dirty work" in the G.I. tract. Which, he said, is the reason why antibiotics affect oral contraceptives - since antibiotics destroy most, if not all, of the helpful bacteria in the intestines that aid in absorption, the BCPs are not absorbed properly by the body. So, long story short, he says I should be okie dokie.

Walgreens Pharmacy says: After a long ramble about how evidence is weakening that antibiotics affect birth control at all (what the...? I`m pretty sure the women that have gotten pregnant while on antibiotics and BCPs would disagree), there was nothing on his computer indicating an interaction between Depo and Ketek. However, he did say there was a flag about Ketek and other methods of contraception and that back up should definitely be used for those.

RiteAid says: It has the potential to effect Depo, so use some back up.

MedicineShoppe says: They couldn`t tell me anything because I didn`t have a prescription for either filled at their pharmacy. Gee, how philantropic of them.

CVS says: They couldn`t find an interaction listed, so I should be good to go sans back up.

Now, for what my Ketek package insert says, which I think is the REALLY interesting part:

"Oral contraceptives: When oral contraceptives containing ethinyl estradiol and levonorgestrel were co-administered with telithromycin, the steady-state AUC of ethinyl estradiol did not change and the steady-state AUC of levonorgestrel was increased by 50%. The pharmacokinetic/pharmacodynamic study showed that telithromycin did not interfere with the antiovulatory effect of oral contraceptives containing ethinyl estradiol and levonorgestrel."

It kind of scares me that Aventis, the maker of freaking Ketek, told me that no studies have been done with Ketek and birth control - and it`s right on the package insert!

So, I`m still kind of confused. More confident that it won`t affect Depo, but still going to be using condoms, at least for while I`m on Ketek and and for a week after and then about from about 2-weeks before my next shot or birth control change happens, just in case it does reduce the amount of the progestin in my system, even if this study did focus on levonorgestrel and not medroxyprogesterone acetate. But, for my own sanity. :)