Drug interactions
Cyclosporine + Ethinyl estradiol-levonorgestrel
Severity: Moderate
Cyclosporine and Ethinyl estradiol-levonorgestrel: moderate 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
Oral contraceptives may inhibit cyclosporine metabolism and increase its blood concentrations. Cyclosporine may also raise levels of the contraceptive hormones. Higher cyclosporine exposure may increase nephrotoxicity and other adverse effects.
What this interaction means in plain words
Cyclosporine and Ethinyl estradiol-levonorgestrel can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Mutual inhibition of CYP3A4-mediated metabolism between the hormones and cyclosporine.
What to do
Monitor cyclosporine trough levels and renal function when starting or stopping the contraceptive, and adjust the cyclosporine dose as needed. Note that estrogen-containing contraceptives may be unsuitable in some transplant patients due to cardiovascular risk.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Cyclosporine with Ethinyl estradiol-levonorgestrel?
MediHelp rates the interaction as moderate. Cyclosporine and Ethinyl estradiol-levonorgestrel can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Oral contraceptives may inhibit cyclosporine metabolism and increase its blood concentrations. Cyclosporine may also raise levels of the contraceptive hormones. Higher cyclosporine exposure may increase nephrotoxicity and other adverse effects.
How serious is the interaction between Cyclosporine and Ethinyl estradiol-levonorgestrel?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporine trough levels and renal function when starting or stopping the contraceptive, and adjust the cyclosporine dose as needed. Note that estrogen-containing contraceptives may be unsuitable in some transplant patients due to cardiovascular risk.
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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