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Drug interactions

Elagolix + Ethinyl estradiol-levonorgestrel

Severity: Major

Elagolix 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

Elagolix suppresses the hypothalamic-pituitary-ovarian axis, and estrogen-containing contraceptives are expected to oppose its effect and reduce its efficacy. Elagolix is also not a reliable contraceptive when combined with hormonal methods, and its own effect on contraceptive efficacy is uncertain.

What this interaction means in plain words

Elagolix 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.

Elagolix belongs to Musculoskeletal; Ethinyl estradiol-levonorgestrel belongs to Endocrine.

Evidence level: Moderate

Why it happens

Pharmacodynamic antagonism between exogenous estrogen/progestin and GnRH receptor antagonism by elagolix.

What to do

Avoid combining the two drugs and use non-hormonal contraception during elagolix and for about one week after stopping. Reassess symptom control if hormonal contraception is considered necessary.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Elagolix with Ethinyl estradiol-levonorgestrel?

MediHelp rates the interaction as major. Elagolix 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. Elagolix suppresses the hypothalamic-pituitary-ovarian axis, and estrogen-containing contraceptives are expected to oppose its effect and reduce its efficacy. Elagolix is also not a reliable contraceptive when combined with hormonal methods, and its own effect on contraceptive efficacy is uncertain.

How serious is the interaction between Elagolix 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: Avoid combining the two drugs and use non-hormonal contraception during elagolix and for about one week after stopping. Reassess symptom control if hormonal contraception is considered necessary.

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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