Drug interactions
Ethinyl estradiol-levonorgestrel + Metyrapone
Severity: Moderate
Ethinyl estradiol-levonorgestrel and Metyrapone: moderate 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
Estrogens raise cortisol-binding globulin and total cortisol levels, which can distort the interpretation of metyrapone testing. A subtherapeutic response to metyrapone has been described in women taking estrogen-containing contraceptives.
What this interaction means in plain words
Ethinyl estradiol-levonorgestrel and Metyrapone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ethinyl estradiol-levonorgestrel belongs to Endocrine; Metyrapone belongs to Endocrine.
Why it happens
Estrogen-induced increase in cortisol-binding globulin alters the hypothalamic-pituitary-adrenal response; the full mechanism is not established.
What to do
Consider pausing estrogen-containing contraceptives before and during metyrapone testing, with an alternative non-hormonal method. Interpret results with awareness of estrogen effects.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Metyrapone
- Metyrapone + Pacritinib Major
- Budesonide + Metyrapone Moderate
- Cortisone + Metyrapone Moderate
- Cyproheptadine + Metyrapone Moderate
- Deflazacort + Metyrapone Moderate
- Desogestrel-ethinyl estradiol + Metyrapone Moderate
Frequently asked questions
Can I take Ethinyl estradiol-levonorgestrel with Metyrapone?
MediHelp rates the interaction as moderate. Ethinyl estradiol-levonorgestrel and Metyrapone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Estrogens raise cortisol-binding globulin and total cortisol levels, which can distort the interpretation of metyrapone testing. A subtherapeutic response to metyrapone has been described in women taking estrogen-containing contraceptives.
How serious is the interaction between Ethinyl estradiol-levonorgestrel and Metyrapone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider pausing estrogen-containing contraceptives before and during metyrapone testing, with an alternative non-hormonal method. Interpret results with awareness of estrogen effects.
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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