Combined hormonal 
contraceptives are less reliable during treatment with 
rifampicin. Breakthrough bleeding and spotting are common, and pregnancies have occurred. Similarly, progestogen-only oral 
contraceptives and emergency hormonal contracep- tives are considered to be less effective in those taking 
rifampicin. 
 For advice on the use of 
enzyme inducers, such as rifampicin, and 
contraceptives, see 
contraceptives. It has been recommended that an alternative or additional form of contraception should also be used for 4 to 8 weeks after stopping 
rifampicin.