Drug interactions
Ethinyl estradiol-levonorgestrel + Ribociclib
Severity: Major
Ethinyl estradiol-levonorgestrel and Ribociclib: 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
Ribociclib is a moderate CYP3A4 inhibitor that may increase exposure to ethinyl estradiol and levonorgestrel. More importantly, hormonal contraceptives are not appropriate in patients with hormone receptor-positive breast cancer who are treated with ribociclib, as they may stimulate tumor growth and are not an effective strategy for the contraception that ribociclib requires.
What this interaction means in plain words
Ethinyl estradiol-levonorgestrel and Ribociclib 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-levonorgestrel belongs to Endocrine; Ribociclib belongs to Oncology.
Why it happens
Ribociclib inhibits CYP3A4, reducing contraceptive steroid clearance; the hormonal exposure itself is also undesirable in hormone-sensitive breast cancer.
What to do
Avoid hormonal contraceptives in this setting and use a non-hormonal method such as a copper IUD or barrier methods. Review the indication with the oncology team.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Frequently asked questions
Can I take Ethinyl estradiol-levonorgestrel with Ribociclib?
MediHelp rates the interaction as major. Ethinyl estradiol-levonorgestrel and Ribociclib 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. Ribociclib is a moderate CYP3A4 inhibitor that may increase exposure to ethinyl estradiol and levonorgestrel. More importantly, hormonal contraceptives are not appropriate in patients with hormone receptor-positive breast cancer who are treated with ribociclib, as they may stimulate tumor growth and are not an effective strategy for the contraception that ribociclib requires.
How serious is the interaction between Ethinyl estradiol-levonorgestrel and Ribociclib?
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 hormonal contraceptives in this setting and use a non-hormonal method such as a copper IUD or barrier methods. Review the indication with the oncology team.
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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