Opill (norgestrel) is a birth control pill that’s taken to help prevent pregnancy. This drug can interact with some other medications and supplements. For example, Opill can interact with St John’s wort.

Opill is a progestin-only birth control pill, also called a minipill. It’s taken to help prevent pregnancy in females* of any age who can become pregnant.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Opill’s possible interactions. And for more information about Opill, including details about its uses, see this article.

Note: Opill has been approved by the Food and Drug Administration (FDA) but is not yet available for purchase. The drug’s manufacturer expects it to be available by early 2024. Opill will be available over the counter (OTC), meaning you’ll be able to purchase it without a prescription. To learn more, talk with your doctor or pharmacist or visit the Opill website.

* We use the term “female” in this article to refer to someone’s sex assigned at birth. To learn more about the difference between sex and gender, see this article.

Before you start taking Opill, tell your doctor and pharmacist about any prescription, OTC, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Opill interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Opill?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Opill. Keep in mind that this table does not include all drugs that may interact with Opill. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
certain seizure medicationscarbamazepine (Tegretol, Carbatrol, others)
• cenobamate (Xcopri)
• phenobarbital (Sezaby)
phenytoin (Dilantin)
can make Opill less effective
certain antibiotics• rifampin (Rifadin, Rimactane)
• rifabutin (Mycobutin)
can make Opill less effective
barbituratesbutalbital/acetaminophen (Butapap, Allzital)
butalbital/acetaminophen/caffeine (Fioricet)
phenobarbital
can make Opill less effective
certain HIV drugs• cobicistat
• efavirenz
• fosamprenavir
can make Opill less effective
bosentan (Tracleer)can make Opill less effective
ulipristal (Ella, Logilia)can make Opill and ulipristal less effective
acitretincan make Opill less effective
armodafinil (Nuvigil)can make Opill less effective
modafinil (Provigil)can make Opill less effective

Certain health conditions or other factors could raise your risk of harm if you take Opill. In such cases, your doctor or pharmacist will likely recommend that you do not take Opill. These are known as contraindications. The list below includes contraindications of Opill.

If you’re pregnant or think you might be: Opill is taken to prevent pregnancy, so you should not take it if you’re already pregnant or think you might be. Opill does not work as emergency birth control (also called the morning-after pill). If you’re pregnant or think you could be, talk with your doctor or pharmacist about your options.

If you’ve had breast cancer or another progestin-sensitive cancer: If you’ve ever had breast cancer oranother cancer that’s sensitive to progestin hormones, you should not take Opill. This is because taking the drug could worsen your breast cancer or raise your risk of it coming back. Talk with your doctor or pharmacist about other types of birth control that may be better options for you.

If you have a liver tumor: If you have a tumor in your liver, cancerous or noncancerous, you should not take Opill. This is because taking the drug could worsen your condition. Talk with your doctor or pharmacist about other forms of birth control that may be better options for you.

If you have irregular vaginal bleeding: If you have bleeding between your periods and you haven’t talked with a doctor about it, you should not take Opill. You should contact your doctor first to address this. Opill can change your menstrual bleeding pattern, so taking it could make it difficult for your doctor to diagnose any menstrual issues you may already have.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Opill or any of its ingredients, you should not take Opill. This is because taking the drug could cause another allergic reaction. You can ask your doctor or pharmacist about other forms of birth control that may be better options for you.

Before you start taking Opill, talk with your doctor or pharmacist if any of the factors above apply to you. They can help determine whether Opill is safe for you to take.

Opill is not known to interact with alcohol. But Opill and alcohol can cause some similar side effects, such as headache, nausea, and dizziness. So you may be more likely to experience these side effects if you drink alcohol while taking Opill.

If you have questions about consuming alcohol while taking Opill, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Opill.

Interaction with certain seizure medications

Opill can interact with certain seizure medications, which are sometimes prescribed to treat epilepsy. Some are also prescribed for other uses, such as nerve pain and bipolar disorder.

Examples of seizure medications that can interact with Opill include:

What could happen

Taking Opill with these seizure medications can make Opill less effective at helping prevent pregnancy.

What you can do

If you’re taking certain seizure medications, your doctor and pharmacist will likely recommend that you do not take Opill for birth control. You can talk with them about other birth control options.

If you need to take certain seizure medications while taking Opill, you should use a backup method of birth control (such as condoms). You should keep using backup birth control for at least 1 month after stopping the seizure medication with your doctor’s approval.

If you have questions about taking Opill with a seizure medication, talk with your doctor or pharmacist.

Interaction with ulipristal

Opill can interact with ulipristal (Ella, Logilia), which is a type of emergency birth control (also called the morning-after pill).

What could happen

Taking Opill with ulipristal or within 5 days of taking ulipristal can make both drugs less effective at helping prevent pregnancy.

What you can do

If you’ve taken ulipristal as emergency birth control, you should wait at least 5 days before you start taking Opill.

If you need emergency birth control while taking Opill (for example, if you had sex without a condom or other barrier method after missing a dose of Opill), you should not take ulipristal. Talk with your doctor or pharmacist about other options.

Interaction with certain antibiotics

Opill can interact with certain antibiotics that are prescribed to treat tuberculosis (TB) and other infections.

Examples of antibiotics that can interact with Opill include:

  • rifampin (Rifadin, Rimactane)
  • rifabutin (Mycobutin)

What could happen

Taking Opill with these antibiotics can make Opill less effective at helping prevent pregnancy.

What you can do

If you’re taking certain antibiotics, your doctor and pharmacist will likely recommend that you do not take Opill for birth control. You can talk with them about other types of birth control that may be better options for you.

If you need to take certain antibiotics while taking Opill, you’ll need to use a backup method of birth control (such as condoms). You should keep using backup birth control for at least 1 month after you finish treatment with the antibiotic.

If you have questions about taking Opill with an antibiotic, talk with your doctor or pharmacist.

Opill may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Opill.

Does Opill interact with supplements?

Before you start taking Opill, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Opill interactions with herbs

Opill can interact with St. John’s wort, an herbal supplement taken to ease symptoms of depression and other conditions.

St. John’s wort can make Opill less effective at helping prevent pregnancy. You should not take St. John’s wort while taking Opill.

Opill interactions with vitamins

There are currently no reports of Opill interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Opill.

Does Opill interact with food?

There are currently no reports of Opill interacting with food. If you have questions about eating certain foods while taking Opill, talk with your doctor.

Does Opill interact with vaccines?

There are currently no reports of Opill interacting with vaccines. If you have questions about getting certain vaccines while taking Opill, talk with your doctor.

Does Opill interact with lab tests?

Opill can affect the results of blood tests for sex hormone-binding globulin and total thyroxine.

If you have questions about having these or other lab tests while taking Opill, talk with the healthcare professional ordering the test.

Does Opill interact with cannabis or CBD?

There are currently no reports of Opill interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Opill.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Opill. Before taking Opill, talk with your doctor or pharmacist about your health history. They’ll determine whether Opill is right for you.

Health conditions or other factors that might interact with Opill include:

Breast cancer or another progestin-sensitive cancer: If you’ve ever had breast cancer or another progestin-sensitive cancer, you should not take Opill.*

Liver problems: If you have a liver tumor, you should not take Opill.* If you have other liver problems, talk with your doctor about whether Opill is right for you.

Irregular vaginal bleeding: If you have bleeding between your periods and you haven’t talked with a doctor about it, you should not take Opill.*

Migraine: If you have migraine, Opill could make your condition worse. Talk with your doctor about whether Opill is right for you.

Pregnancy: Opill is taken to help prevent pregnancy, so you should not take it if you’re already pregnant or think you might be. Opill won’t work as emergency birth control (also called the morning-after pill). If you’re pregnant or think you could be, talk with your doctor or pharmacist about your options.

Breastfeeding: Opill is generally considered safe to take while breastfeeding. However, if you’re breastfeeding, you should still talk with your doctor about whether Opill is right for you.

Allergic reaction: If you’ve had an allergic reaction to Opill or any of its ingredients, you should not take Opill.*

* To learn more, see the “When should I avoid Opill?” section above.

Taking certain steps can help you avoid interactions with Opill. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Opill treatment.

It’s also important to understand Opill’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Opill, ask your pharmacist to print a copy for you.)

If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Taking Opill exactly as prescribed can also help prevent interactions.

If you still have questions about Opill and its possible interactions, talk with your doctor or pharmacist.

Questions you may want to ask include:

  • Which antibiotics interact with Opill?
  • Can I take pain relievers or allergy medications with Opill?
  • Can I take other medications at the same time of day as Opill?

To learn more about Opill, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.