Drug interactions
Ethinyl estradiol-drospirenone + Mitotane
Severity: Major
Ethinyl estradiol-drospirenone and Mitotane: 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
Mitotane is a strong CYP3A4 inducer with a long-lasting effect that can markedly lower ethinyl estradiol and drospirenone exposure. Contraceptive failure and breakthrough bleeding are possible, even after mitotane is stopped.
What this interaction means in plain words
Ethinyl estradiol-drospirenone and Mitotane 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.
Ethinyl estradiol-drospirenone belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Strong, persistent CYP3A4 induction by mitotane increases clearance of both contraceptive hormones.
What to do
Use a non-hormonal contraceptive method such as a copper IUD or barrier method during and for months after mitotane therapy.
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 Ethinyl estradiol-drospirenone
- Ethinyl estradiol-drospirenone + Fezolinetant Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir Contraindicated
- Ethinyl estradiol-drospirenone + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-drospirenone Major
- Amobarbital + Ethinyl estradiol-drospirenone Major
Other interactions of Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Ethinyl estradiol-drospirenone with Mitotane?
MediHelp rates the interaction as major. Ethinyl estradiol-drospirenone and Mitotane 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. Mitotane is a strong CYP3A4 inducer with a long-lasting effect that can markedly lower ethinyl estradiol and drospirenone exposure. Contraceptive failure and breakthrough bleeding are possible, even after mitotane is stopped.
How serious is the interaction between Ethinyl estradiol-drospirenone and Mitotane?
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 contraceptive method such as a copper IUD or barrier method during and for months after mitotane therapy.
What other medicines interact with Ethinyl estradiol-drospirenone?
MediHelp also lists interactions of Ethinyl estradiol-drospirenone with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Ethinyl estradiol-drospirenone page.
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