Drug interactions
Atazanavir + Desogestrel-ethinyl estradiol
Severity: Major
Atazanavir and Desogestrel-ethinyl estradiol: major 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
Atazanavir alters ethinyl estradiol exposure, and when boosted with ritonavir can reduce it, while progestin exposure may increase. This may lead to reduced contraceptive reliability, breakthrough bleeding, or progestin-related adverse effects.
What this interaction means in plain words
Atazanavir and Desogestrel-ethinyl estradiol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Desogestrel-ethinyl estradiol belongs to Endocrine.
Why it happens
Atazanavir inhibits CYP3A4 and UGT1A1, while ritonavir boosting induces glucuronidation, altering ethinyl estradiol and progestin levels.
What to do
Use a contraceptive containing at least 30 mcg ethinyl estradiol with unboosted atazanavir, or choose an alternative or additional non-hormonal method. Avoid products with less than 30 mcg ethinyl estradiol with boosted atazanavir.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Desogestrel-ethinyl estradiol
- Desogestrel-ethinyl estradiol + Fezolinetant Contraindicated
- Aminocaproic acid + Desogestrel-ethinyl estradiol Major
- Amobarbital + Desogestrel-ethinyl estradiol Major
- Anastrozole + Desogestrel-ethinyl estradiol Major
- Apalutamide + Desogestrel-ethinyl estradiol Major
- Belzutifan + Desogestrel-ethinyl estradiol Major
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Desogestrel-ethinyl estradiol?
MediHelp rates the interaction as major. Atazanavir and Desogestrel-ethinyl estradiol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir alters ethinyl estradiol exposure, and when boosted with ritonavir can reduce it, while progestin exposure may increase. This may lead to reduced contraceptive reliability, breakthrough bleeding, or progestin-related adverse effects.
How serious is the interaction between Atazanavir and Desogestrel-ethinyl estradiol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a contraceptive containing at least 30 mcg ethinyl estradiol with unboosted atazanavir, or choose an alternative or additional non-hormonal method. Avoid products with less than 30 mcg ethinyl estradiol with boosted atazanavir.
What other medicines interact with Desogestrel-ethinyl estradiol?
MediHelp also lists interactions of Desogestrel-ethinyl estradiol with, for example, Fezolinetant, Aminocaproic acid, Amobarbital. The full list is on the Desogestrel-ethinyl estradiol page.
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