Drug interactions
Carbamazepine + Desogestrel-ethinyl estradiol
Severity: Major
Carbamazepine and Desogestrel-ethinyl estradiol: 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
Carbamazepine is a strong enzyme inducer that markedly lowers ethinyl estradiol and progestin levels, with breakthrough bleeding and documented contraceptive failures. Hormonal contraceptives may also modestly alter carbamazepine concentrations.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Desogestrel-ethinyl estradiol belongs to Endocrine.
Why it happens
Induction of CYP3A4 and other hepatic enzymes by carbamazepine accelerates contraceptive steroid clearance.
What to do
Use a non-enzyme-inducer-sensitive method such as a copper IUD, levonorgestrel IUD or DMPA instead of combined oral contraceptives. Continue backup contraception for weeks after stopping carbamazepine.
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
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
- Atazanavir + Desogestrel-ethinyl estradiol Major
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Desogestrel-ethinyl estradiol?
MediHelp rates the interaction as major. Carbamazepine 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. Carbamazepine is a strong enzyme inducer that markedly lowers ethinyl estradiol and progestin levels, with breakthrough bleeding and documented contraceptive failures. Hormonal contraceptives may also modestly alter carbamazepine concentrations.
How serious is the interaction between Carbamazepine 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 non-enzyme-inducer-sensitive method such as a copper IUD, levonorgestrel IUD or DMPA instead of combined oral contraceptives. Continue backup contraception for weeks after stopping carbamazepine.
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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