Drug interactions
Cenobamate + Ethinyl estradiol-drospirenone
Severity: Major
Cenobamate and Ethinyl estradiol-drospirenone: 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
Cenobamate induces CYP3A4 and can lower ethinyl estradiol exposure, which may reduce contraceptive effectiveness and increase the risk of breakthrough bleeding or unintended pregnancy. Drospirenone exposure may also be reduced.
What this interaction means in plain words
Cenobamate and Ethinyl estradiol-drospirenone 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.
Cenobamate belongs to Central Nervous System; Ethinyl estradiol-drospirenone belongs to Endocrine.
Why it happens
Cenobamate induces CYP3A4, increasing the metabolism of ethinyl estradiol and progestins.
What to do
Advise an additional or alternative non-hormonal contraceptive method while on cenobamate and for a period after stopping. Consider a non-hormonal method or an IUD as the primary option.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Ethinyl estradiol-drospirenone?
MediHelp rates the interaction as major. Cenobamate and Ethinyl estradiol-drospirenone 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. Cenobamate induces CYP3A4 and can lower ethinyl estradiol exposure, which may reduce contraceptive effectiveness and increase the risk of breakthrough bleeding or unintended pregnancy. Drospirenone exposure may also be reduced.
How serious is the interaction between Cenobamate and Ethinyl estradiol-drospirenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise an additional or alternative non-hormonal contraceptive method while on cenobamate and for a period after stopping. Consider a non-hormonal method or an IUD as the primary option.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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