What are the food-drug interactions of combined oral contraceptives?

There are several food-drug interactions that can affect the effectiveness of combined oral contraceptives (COCs). Some of the most common interactions include:

1. Grapefruit juice: Grapefruit juice can inhibit the metabolism of estrogen in the liver, potentially increasing estrogen levels in the body and increasing the risk of side effects.

2. St. John's Wort: St. John's Wort is a herbal supplement that can induce the metabolism of estrogen in the liver, potentially reducing the effectiveness of COCs.

3. Antibiotics: Some antibiotics, such as rifampin and tetracycline, can reduce the effectiveness of COCs by increasing the metabolism of estrogen in the liver.

4. Anticonvulsants: Some anticonvulsant medications, such as phenytoin and carbamazepine, can reduce the effectiveness of COCs by increasing the metabolism of estrogen in the liver.

5. Antifungal medications: Some antifungal medications, such as griseofulvin, can reduce the effectiveness of COCs by increasing the metabolism of estrogen in the liver.

It is important to talk to your healthcare provider about any medications or supplements you are taking before starting COCs to ensure that there are no potential interactions that could affect their effectiveness.