Drug interactions
Alprazolam + Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate
Severity: Moderate
Alprazolam and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Oral contraceptives containing ethinylestradiol can reduce the oxidative clearance of some benzodiazepines, including alprazolam. This may raise alprazolam levels and cause more pronounced sedation or psychomotor impairment. The effect is usually modest.
What this interaction means in plain words
Alprazolam and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Ethinylestradiol weakly inhibits CYP3A4-mediated metabolism of alprazolam, reducing its clearance.
What to do
Monitor for excess sedation and adjust the alprazolam dose if needed. Tell patients to report increased drowsiness or impaired coordination.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to see why Alprazolam and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate interact, what to do about it, and the sources.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate?
MediHelp rates the interaction as moderate. Alprazolam and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Oral contraceptives containing ethinylestradiol can reduce the oxidative clearance of some benzodiazepines, including alprazolam. This may raise alprazolam levels and cause more pronounced sedation or psychomotor impairment. The effect is usually modest.
How serious is the interaction between Alprazolam and Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excess sedation and adjust the alprazolam dose if needed. Tell patients to report increased drowsiness or impaired coordination.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
