Doctors Lounge - Gynecology Answers
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Forum Name: Gynecology
|nordicat - Sat Jul 31, 2010 10:28 pm||
Hello! I have been informed by my pharmacist and sleep doctor that the Provigil (modafinil) I have been prescribed for Narcolepsy will interact with oral contraceptives. Since this discovery, I have looked into several different options and have heard some VERY conflicting advice!
For example, some sources say that a high-dose combined oral contraceptive pill "should" work, or any IUD, or basically anything that doesn't contain an estrogen should work. Other sources say NO hormonal contraceptive will work (including Mirena IUD [hormonal IUD], the patch, the ring, and Depo Provera shot) and that only a copper IUD like ParaGard will work with Provigil. Obviously, condoms will work just fine, but I would really like a more long-term option.
My gynecologist and I were considering a Mirena IUD, but the Provigil prescribing information and several other sources imply that it would be rendered ineffective!
What are my options for reliable birth control while using this medication? Thank you!
|Debbie Miller, RN - Wed Aug 04, 2010 2:47 pm||
I believe Mirena IUD would be an excellent choice. The literature says that Provigil may decrease the effectiveness of hormonal birth control such as pills, injections and implants (not IUDs). Even with that slight risk, the two are sometimes used together even in the forms listed above.
Mirena does contain a hormone as an additional protection but that is not its primary action so you should not need to worry too much about this combination. At one time it was a concern that all antibiotics may decrease effectiveness but that has been largely shown to be wrong, with Rifampin being the only one that really presents a risk.
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