Drug interactions
Cenobamate + Ethinyl estradiol-levonorgestrel
Severity: Major
Cenobamate and Ethinyl estradiol-levonorgestrel: 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 exposure to ethinyl estradiol and levonorgestrel. This may reduce contraceptive efficacy and raise the risk of unintended pregnancy and breakthrough bleeding.
What this interaction means in plain words
Cenobamate and Ethinyl estradiol-levonorgestrel 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-levonorgestrel belongs to Endocrine.
Why it happens
Cenobamate induces CYP3A4 (and other enzymes), increasing metabolism of both contraceptive hormones.
What to do
Advise an additional or alternative non-hormonal contraceptive method during and for some time after cenobamate therapy. Consider a higher-dose or alternative contraceptive approach, such as an intrauterine device.
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-levonorgestrel
- Ethinyl estradiol-levonorgestrel + Fezolinetant Contraindicated
- Ethinyl estradiol-levonorgestrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-levonorgestrel Major
- Amobarbital + Ethinyl estradiol-levonorgestrel Major
- Anastrozole + Ethinyl estradiol-levonorgestrel Major
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Ethinyl estradiol-levonorgestrel?
MediHelp rates the interaction as major. Cenobamate and Ethinyl estradiol-levonorgestrel 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 exposure to ethinyl estradiol and levonorgestrel. This may reduce contraceptive efficacy and raise the risk of unintended pregnancy and breakthrough bleeding.
How serious is the interaction between Cenobamate and Ethinyl estradiol-levonorgestrel?
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 during and for some time after cenobamate therapy. Consider a higher-dose or alternative contraceptive approach, such as an intrauterine device.
What other medicines interact with Ethinyl estradiol-levonorgestrel?
MediHelp also lists interactions of Ethinyl estradiol-levonorgestrel with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-levonorgestrel page.
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