An adolescent will begin taking the combination oral contraceptive pill (OCP). Which supplement will the primary care pediatric nurse practitioner caution the adolescent to avoid while taking OCPs?

An adolescent will begin taking the combination oral contraceptive pill (OCP). Which supplement will the primary care pediatric nurse practitioner caution the adolescent to avoid while taking OCPs?

• A. Ginkgo
• B. Kava
• C. St. John's wort
• D. Valerian

Answer: (C)

Herbal supplements can change how hormonal contraceptives work by altering liver enzyme activity. St. John’s wort induces enzymes that metabolize ethinyl estradiol and progestins, which speeds up their breakdown and lowers their blood levels. This reduces the effectiveness of the combination oral contraceptive and raises the chance of unintended pregnancy. Because of this interaction, St. John’s wort should be avoided while using OCPs. Ginkgo, Kava, and Valerian don’t have the same central effect on the enzymes that metabolize oral contraceptives, so they aren’t known to compromise contraceptive efficacy in the same way. If any supplement is considered, it’s important to discuss it with a clinician first.

Herbal supplements can change how hormonal contraceptives work by altering liver enzyme activity. St. John’s wort induces enzymes that metabolize ethinyl estradiol and progestins, which speeds up their breakdown and lowers their blood levels. This reduces the effectiveness of the combination oral contraceptive and raises the chance of unintended pregnancy. Because of this interaction, St. John’s wort should be avoided while using OCPs.

Ginkgo, Kava, and Valerian don’t have the same central effect on the enzymes that metabolize oral contraceptives, so they aren’t known to compromise contraceptive efficacy in the same way. If any supplement is considered, it’s important to discuss it with a clinician first.