Drug interactions
Ethinyl estradiol-levonorgestrel + Topiramate
Severity: Moderate
Ethinyl estradiol-levonorgestrel and Topiramate: 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
Topiramate can lower ethinyl estradiol exposure in a dose-dependent manner, mainly at higher doses. Contraceptive efficacy may be reduced and breakthrough bleeding can occur. Topiramate is also teratogenic, so contraceptive reliability matters.
What this interaction means in plain words
Ethinyl estradiol-levonorgestrel and Topiramate 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; Topiramate belongs to Central Nervous System.
Why it happens
Weak, dose-dependent induction of CYP3A4 increases estrogen metabolism.
What to do
At doses above 200 mg/day consider a higher-dose estrogen product or additional non-hormonal contraception. Counsel patients to report breakthrough bleeding.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ethinyl estradiol-levonorgestrel and Topiramate, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Topiramate
Frequently asked questions
Can I take Ethinyl estradiol-levonorgestrel with Topiramate?
MediHelp rates the interaction as moderate. Ethinyl estradiol-levonorgestrel and Topiramate 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. Topiramate can lower ethinyl estradiol exposure in a dose-dependent manner, mainly at higher doses. Contraceptive efficacy may be reduced and breakthrough bleeding can occur. Topiramate is also teratogenic, so contraceptive reliability matters.
How serious is the interaction between Ethinyl estradiol-levonorgestrel and Topiramate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: At doses above 200 mg/day consider a higher-dose estrogen product or additional non-hormonal contraception. Counsel patients to report breakthrough bleeding.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
