Drug interactions
Efavirenz + Ethinyl estradiol-levonorgestrel
Severity: Major
Efavirenz 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
Efavirenz can alter contraceptive steroid exposure and has been associated with contraceptive failure with implants and possibly pills. Efavirenz is also teratogenic concern, making reliable contraception important.
What this interaction means in plain words
Efavirenz 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.
Efavirenz belongs to Anti Virals; Ethinyl estradiol-levonorgestrel belongs to Endocrine.
Why it happens
Induction of CYP3A4 by efavirenz increases metabolism of ethinyl estradiol and levonorgestrel.
What to do
Use a reliable alternative or additional method such as a copper IUD or condoms rather than relying on combined hormonal contraception.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Efavirenz with Ethinyl estradiol-levonorgestrel?
MediHelp rates the interaction as major. Efavirenz 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. Efavirenz can alter contraceptive steroid exposure and has been associated with contraceptive failure with implants and possibly pills. Efavirenz is also teratogenic concern, making reliable contraception important.
How serious is the interaction between Efavirenz 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: Use a reliable alternative or additional method such as a copper IUD or condoms rather than relying on combined hormonal contraception.
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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