How can I prescribe OCPs after emergency contraceptive pills? #602/15

Q:        A woman is taking the combined oral contraceptive, Ortho Tri-Cyclen.  She is on an antibiotic and doesn’t use a backup method.  She wants emergency contracepitve pills as a backup contraception.  I will prescribe her emergency contraceptive pills per her request.

My question is, should she be prescribed Ortho Tri-Cyclen while taking Plan B?        

A:        Tell her that she need NOT stop Ortho Tri-Cyclen at all. 

Your question raises two additional issues.  First, did she need to use additional contraception while on a broad spectrum antibiotic such as dozycycline, ampicillin or erythrompcm?  Probably not.  The Planned Parenthood Federation of America makes this clear statement in their National Medical Guidelines: “There is no pharmacological evidence that acute or chronic use of systemic antibiotics (e.g. tetracycline, ampicillin) decreases the efficiency of low-dose COCs in women taking them correctly.”

Because of the controversy and possible medical-legal implications should a pregnancy occur, there is no problem if she takes Plan B.  However, it could make her feel more comfortable if she takes Plan B.

Robert A. Hatcher MD, MPH

Emeritus Professor of Gynecology and Obstetrics

Emory University School of Medicine

Atlanta, GA

June 24, 2015 

Key Words: oral contraceptive pills, emergency contraceptive pills, Plan B, antibiotic, backup method, prescribed, Ortho Tri-Cyclen pills, broad spectrum antibiotic, doxycycline, ampicillin, erythromycm, Planned Parenthood Federation of America, National Medical Guidelines, pharmacological evidence, acute, chronic, systemic, controversy, implications

To learn more about the advantages and disadvantages of the Depo-Provera injections, go to:   You can order all of these books listed below from our website or by calling 404-875-5001. 

Current Books:

Contraceptive Technology 20th edition

Managing Contraception 2015-2016 edition

Choices 2014 edition 

The authors advise consultation of a primary-care provider or a specialist before making decisions about, managing, or treating any problem discussed in these questions and answers.  Under no circumstances should the information provided on this website be used instead of, or to override the judgment of the treating provider.


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Posted on

June 29, 2015