Drug interactions
Butalbital + Ulipristal
Severity: Major
Butalbital and Ulipristal: major interaction.
Last updated Sources: US FDA label
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
Butalbital, a barbiturate, induces CYP3A4 and can lower ulipristal concentrations. This may reduce the effectiveness of emergency contraception and lead to unintended pregnancy.
What this interaction means in plain words
Butalbital and Ulipristal 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.
Why it happens
Barbiturate induction of CYP3A4 increases ulipristal metabolism.
What to do
Avoid ulipristal in patients taking butalbital and use a copper intrauterine device or levonorgestrel with a possible dose increase instead.
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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References
Frequently asked questions
Can I take Butalbital with Ulipristal?
MediHelp rates the interaction as major. Butalbital and Ulipristal 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. Butalbital, a barbiturate, induces CYP3A4 and can lower ulipristal concentrations. This may reduce the effectiveness of emergency contraception and lead to unintended pregnancy.
How serious is the interaction between Butalbital and Ulipristal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid ulipristal in patients taking butalbital and use a copper intrauterine device or levonorgestrel with a possible dose increase instead.
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