BPC-157 and Hormonal Contraceptives: What the Evidence Actually Shows

Does BPC-157 interact with hormonal contraceptives?

It is unknown whether BPC-157 changes how well hormonal contraceptives work. The interactions documented on contraceptive labels involve a specific list of drugs, and the mechanism the labels describe is enzyme induction, which can lower hormone levels [1]. FDA says BPC-157's molecular targets have not been identified and its mechanisms remain poorly understood [4].

What the birth control labels actually list

The Sprintec (norgestimate and ethinyl estradiol) label states that no drug-drug interaction studies were conducted with Sprintec, then sets out the interactions that matter for the class [1]. Drugs and herbal products that induce CYP3A4 may lower contraceptive hormone concentrations and potentially reduce effectiveness or increase breakthrough bleeding. The label names phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John's wort. It advises counselling a back-up or alternative contraceptive method while an inducer is used and for 28 days after it is stopped [1]. The Slynd (drospirenone) and Twirla (levonorgestrel/ethinyl estradiol patch) labels carry the same inducer advice [2][3].

Other entries on the same label run in both directions. HIV and hepatitis C drugs can push estrogen or progestin levels up or down [1]. Atorvastatin or rosuvastatin raise ethinyl estradiol AUC by about 20 to 25%, and itraconazole, voriconazole, fluconazole, grapefruit juice and ketoconazole may raise hormone levels [1]. Colesevelam lowers ethinyl estradiol AUC, and separating the doses by 4 hours reduces the effect [1]. In the other direction, ethinyl estradiol-containing pills may raise levels of cyclosporine, prednisolone, theophylline, tizanidine and voriconazole, and lower levels of lamotrigine, which may reduce seizure control [1].

BPC-157 appears in none of these lists on the Sprintec label [1].

What is known about BPC-157 absorption

The only absorption data FDA describes come from rectal enemas in two early studies, where the peptide was mostly not detectable in blood; FDA judged it appears not to be absorbed systemically by that route [4]. FDA noted websites selling BPC-157 as capsules, injections, oral sprays and nasal sprays, some labeled for research purposes only [4]. The rectal data say nothing about those forms, or about whether the peptide changes how a contraceptive hormone is handled by the body.

Do animal studies suggest BPC-157 affects clotting?

In rats, reviewers describe strong angiogenic potential, protection of the endothelium, prevention and reversal of thrombus formation after abdominal aorta anastomosis, and activity on the nitric oxide system [8].

FDA's toxicology review reported mixed findings. In 28-day intramuscular studies, BPC-157 shortened clotting time (aPTT) in rats and prolonged it in dogs, and raised liver enzyme (ALT), glucose and triglyceride levels [4]. Longer studies and cancer-risk studies were not available [4]. None of these experiments involved a contraceptive. The two-person intravenous pilot tested biomarkers of the heart, liver, kidneys, thyroid and blood glucose [9].

What the contraceptive contributes on its own

The Sprintec label puts the risk of venous thromboembolism in women using combined oral contraceptives at 3 to 9 cases per 10,000 woman-years, highest in the first year of use and when restarting after a break of 4 weeks or longer [1]. The same label notes that pregnancy increases VTE risk as much or more than combined pill use [1]. Its boxed warning says smoking raises the risk of serious cardiovascular events from combined pills, that the risk climbs with age and with the number of cigarettes smoked, and that combined pills are contraindicated in women over 35 who smoke [1]. Twirla's boxed warning also lists a BMI of 30 kg/m2 or higher as a contraindication [2]. The progestin-only pill Slynd carries no boxed warning in its current label record [3].

This page covers combined pills, the combined patch, the vaginal ring and the progestin-only pill Slynd. Implants, injectable depot medroxyprogesterone acetate and hormonal intrauterine devices are different products and are not addressed here.

Regulatory status of BPC-157

BPC-157 is not an FDA-approved drug. No approved product contains it, there is no US Pharmacopeia or National Formulary monograph for it, and FDA's July 2026 review found no approved product containing it in any country it searched [4]. The human literature is thin: a 2026 systematic review found three studies covering 30 patients in orthopaedic and regenerative use, all of poor methodological quality, with certainty of evidence rated very low [5]. FDA's own review found five small clinical studies, including a 2-person pilot, and concluded there is insufficient clinical safety information to characterise the safety profile [4].

Compounding status has moved without settling. BPC-157 sat in FDA's category 2 group for bulk substances that may present significant safety risks from September 2023 until April 22, 2026, when it moved to a table of nominations withdrawn by the nominators; that move was not a finding of safety. It is not in category 1, the group FDA says it generally will not act against compounders for [10][11]. In July 2026, FDA's Pharmacy Compounding Advisory Committee considered BPC-157 for the bulk-substance list; committee advice is nonbinding, and BPC-157 was not thereby added to the list [12]. FDA's own reviewers had proposed that it not be added, citing poor chemical characterisation, little safety and immunogenicity information, and insufficient evidence for ulcerative colitis [4]. On October 28, 2026 HHS announced a draft enforcement-discretion policy covering six peptides including BPC-157, limited to the acetate form, a single active ingredient and a patient-specific prescription; the notice states it does not establish rights for any person and is not binding [13][14].