Drug interactions
Desogestrel-ethinyl estradiol + Rifampin
Severity: Major
Desogestrel-ethinyl estradiol and Rifampin: 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
Rifampin markedly reduces contraceptive steroid exposure and has been associated with breakthrough bleeding and unintended pregnancies. The effect begins within days and persists after stopping.
What this interaction means in plain words
Desogestrel-ethinyl estradiol and Rifampin 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.
Why it happens
Potent induction of CYP3A4 and other enzymes (and glucuronidation) by rifampin increases clearance of both hormones.
What to do
Use a non-hormonal or non-oral-dependent method such as a copper IUD, levonorgestrel IUS or DMPA during therapy and for about 4 weeks after stopping.
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
Frequently asked questions
Can I take Desogestrel-ethinyl estradiol with Rifampin?
MediHelp rates the interaction as major. Desogestrel-ethinyl estradiol and Rifampin 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. Rifampin markedly reduces contraceptive steroid exposure and has been associated with breakthrough bleeding and unintended pregnancies. The effect begins within days and persists after stopping.
How serious is the interaction between Desogestrel-ethinyl estradiol and Rifampin?
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-hormonal or non-oral-dependent method such as a copper IUD, levonorgestrel IUS or DMPA during therapy and for about 4 weeks after stopping.
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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