Drug interactions
Cenobamate + Levonorgestrel
Severity: Major
Cenobamate and 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 may lower systemic levonorgestrel, reducing the reliability of oral or emergency levonorgestrel contraception. The local effect of an intrauterine system is less affected.
What this interaction means in plain words
Cenobamate and 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; Levonorgestrel belongs to Endocrine.
Why it happens
CYP3A4 induction by cenobamate increases levonorgestrel metabolism.
What to do
Advise additional or alternative non-hormonal contraception; for emergency contraception prefer a copper IUD, or consider a higher levonorgestrel dose if guidance supports it.
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 Levonorgestrel
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Levonorgestrel?
MediHelp rates the interaction as major. Cenobamate and 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 may lower systemic levonorgestrel, reducing the reliability of oral or emergency levonorgestrel contraception. The local effect of an intrauterine system is less affected.
How serious is the interaction between Cenobamate and 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 additional or alternative non-hormonal contraception; for emergency contraception prefer a copper IUD, or consider a higher levonorgestrel dose if guidance supports it.
What other medicines interact with Levonorgestrel?
MediHelp also lists interactions of Levonorgestrel with, for example, Amobarbital, Apalutamide, Belzutifan. The full list is on the Levonorgestrel page.
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