Drug interactions
Ethinylestradiol and Cyproterone Acetate + Fluconazole
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.
Overview
Fluconazole can increase systemic exposure to ethinylestradiol and cyproterone acetate, elevating risk of estrogen/progestin adverse effects (e.g., nausea, breast tenderness, headache) and thromboembolic risk; it may also heighten cyproterone-associated hepatotoxicity, especially with repeated or higher-dose fluconazole.
Mechanism of action
Pharmacokinetic—fluconazole inhibits CYP3A4, CYP2C9, and CYP2C19, reducing metabolism of ethinylestradiol and cyproterone acetate and increasing their plasma concentrations.
Clinical management
If coadministration is necessary, use the lowest effective fluconazole dose for the shortest duration. Monitor for estrogen/progestin adverse effects and signs/symptoms of VTE. For multi-day or higher-dose fluconazole (e.g., ≥200 mg/day), consider baseline and follow-up liver function tests and reassess therapy if hepatic or hormone-related adverse effects emerge.
Drug reference
References
- Diflucan (fluconazole) Prescribing Information — FDA Label
- Cyproterone acetate/ethinylestradiol (Diane 35) Summary of Product Characteristics — EMA
- Ethinyl Estradiol: Drug Interactions — Lexicomp
- Fluconazole: Drug Information and interactions with hormonal contraceptives — UpToDate
Frequently asked questions
Can I take Ethinylestradiol and Cyproterone Acetate with Fluconazole?
The interaction is rated: Moderate. Fluconazole can increase systemic exposure to ethinylestradiol and cyproterone acetate, elevating risk of estrogen/progestin adverse effects (e.g., nausea, breast tenderness, headache) and thromboembolic risk; it may also heighten cyproterone-associated hepatotoxicity, especially with repeated or higher-dose fluconazole.
How serious is the interaction between Ethinylestradiol and Cyproterone Acetate and Fluconazole?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Ethinylestradiol and Cyproterone Acetate and Fluconazole managed?
If coadministration is necessary, use the lowest effective fluconazole dose for the shortest duration. Monitor for estrogen/progestin adverse effects and signs/symptoms of VTE. For multi-day or higher-dose fluconazole (e.g., ≥200 mg/day), consider baseline and follow-up liver function tests and reassess therapy if hepatic or hormone-related adverse effects emerge.
Why do Ethinylestradiol and Cyproterone Acetate and Fluconazole interact?
Pharmacokinetic—fluconazole inhibits CYP3A4, CYP2C9, and CYP2C19, reducing metabolism of ethinylestradiol and cyproterone acetate and increasing their plasma concentrations.
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