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Drug interactions

Enzalutamide + Ethinyl estradiol-levonorgestrel

Severity: Major

Enzalutamide 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

Enzalutamide is a strong CYP3A4 inducer and can lower circulating levels of ethinyl estradiol and levonorgestrel. This may lead to contraceptive failure and unintended pregnancy.

What this interaction means in plain words

Enzalutamide 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.

Enzalutamide belongs to Endocrine; Ethinyl estradiol-levonorgestrel belongs to Endocrine.

Evidence level: Moderate

Why it happens

Induction of CYP3A4 increases hepatic and intestinal metabolism of both contraceptive hormones.

What to do

Do not rely on combined hormonal contraception alone; use a non-hormonal method such as a copper IUD or consistent barrier method during treatment and for a period after stopping enzalutamide.

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 Enzalutamide with Ethinyl estradiol-levonorgestrel?

MediHelp rates the interaction as major. Enzalutamide 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. Enzalutamide is a strong CYP3A4 inducer and can lower circulating levels of ethinyl estradiol and levonorgestrel. This may lead to contraceptive failure and unintended pregnancy.

How serious is the interaction between Enzalutamide 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: Do not rely on combined hormonal contraception alone; use a non-hormonal method such as a copper IUD or consistent barrier method during treatment and for a period after stopping enzalutamide.

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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