QuestionI am currently taking Tri-Sprintec. I take my pill around the same time each
evening, shortly before bed (between 11pm and 1am). I am interested in
trying St. John's Wort, but I have heard that it inhibits enzymes in oral
contraceptives. Most of the information I've found is inconclusive, but
apparently there is some evidence that it could decrease the effectiveness,
and I'm wondering if I were to take a St. John's Wort supplement when I got
up in the morning and take my Tri-Sprintec at night, would this avoid an
interaction? If I take them several hours apart, is there still a considerable
risk? Along those lines, is grapefruit juice unsafe as well? I've read lots of
conflicting articles and I'm a bit confused. Thank you for any info you can
give me!
AnswerI agree with you that there is conflicting information out there. As far as I know, no one has all the answers. Relative to St. John's Wort, it's thought that it affects metabolism of birth control pills and some other medications by its action on liver enzymes. I think this means that taking pills at different times of the day won't really make any difference. For grapefruit juice, I don't think there is much concern that it will decrease pill effectiveness, and not taking the juice and the pill at the same time would probably be helpful. For St. John's Wort, it appears that it may decrease effectiveness of the pill, so you should probably take it with that in mind. Perhaps use a backup method of birth control while taking SJW.
