Why should I be concerned about contraception while taking TB medication?

The effectiveness of hormonal contraception, including oral, implants and long-lasting injection are reduced by one of the main TB medicines in your treatment. This medicine is called Rifampicin.

It is important you follow the advice given by the TB Team and if you have any questions about your treatment or contraception while on TB treatment, please speak to the TB Team or your GP.

Rifampicin and contraception

Rifampicin is the main antibiotic in your TB treatment. It is in a number of branded medicines such as Rifater®, Rifinah®, Rifadin® and Rifadin® oral suspension.

Your contraception will be less effective while taking Rifampicin. It’s effects on reducing contraception can last up to 28 days, even after you stop taking Rifampicin.

You should continue to follow this advice for 28 days after stopping Rifampicin.

You will need to change to a different method of contraception if you are using a: 

• combined oral contraception also known as “the Pill”, such as Microgynon 30® and Rigevidon®
• combined transdermal patch, for example Evra®
• vaginal ring, such as Nuvaring®
• progesterone only pill, also known as the “mini pill”, such as Cerelle® or Zelleta®
• progesterone only implant, for example Nexplanon®.

Visit www.kent.gov.uk/sexualhealth for clinics near you.

There is no need to change your contraception if you are using a:

• progesterone depot injection, such as Depo-Provera® or Sayana Press®
• Levonorgestrel containing intrauterine system (IUS), for example Mirena®
• “copper coil” intrauterine device.

Emergency oral contraception (EOC)

While on Rifampicin, and for 28 days after you finish your TB treatment, the effectiveness of emergency oral contraception, for example Levonorgestrel, may be reduced. You would need to take a larger dose of Levonorgestrel if you require this medicine as emergency contraception.

A “copper coil” intrauterine device is the most effective form of emergency contraception which can also be used for ongoing contraception.

Ulipristal (EllaOne®) is not recommended if you are on Rifampicin or within 28 days of stopping Rifampicin.

Please see your GP for emergency contraception (EOC) and bring this leaflet with you.

EOC is sold at most community pharmacies and is also available free of charge for people under 30 (if assessed as suitable by the pharmacist).

Urgent Treatment Centres (UTCs) or Minor Injury Units (MIUs) may also provide EOC (Levonorgestrel). It is important to tell all medical providers about your TB medication.

Visit www.nhs.uk/nhs-services/urgent-and-emergency-care-services/ to find a service near you or phone NHS 111.

Pregnancy

We have very limited evidence about the effects of TB medicines on unborn babies so pregnancy while on your TB medication is not recommended.

Please speak to your TB nurses, or a healthcare professional if you have any intention of conceiving while on your TB medication.

Other TB medicines and contraception

No additional precautions are required if taking Isoniazid, Pyrazinamide or Ethambutol, however, if Rifampicin is part of your treatment, the advice for Rifampicin must be followed.

If you are prescribed a different antibiotic for TB not listed above, the TB Team will advise you if there is any need to change your contraception.

General advice

• Use condoms to prevent sexually transmitted infections (STIs).
• Always use condoms to help prevent HIV and other bloodborne viruses.
• You can use emergency contraception if a condom fails or is not used.
• If you become pregnant while on your TB treatment, contact the TB Team as soon as possible.
• Do not stop treatment unless we advise you to.