Drug interactions
Levonorgestrel + Mitotane
Severity: Major
Levonorgestrel and Mitotane: 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
Mitotane is a potent enzyme inducer whose effect persists for weeks to months after stopping. It can substantially reduce levonorgestrel exposure and so compromise contraceptive efficacy, especially for oral and emergency use.
What this interaction means in plain words
Levonorgestrel 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.
Levonorgestrel belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Strong induction of CYP3A4 by mitotane accelerates levonorgestrel metabolism.
What to do
Use a non-hormonal method such as a copper IUD or barrier contraception, and continue it for an extended period after stopping mitotane. For emergency contraception, prefer a copper IUD.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Levonorgestrel and Mitotane, 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 Levonorgestrel
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 Levonorgestrel with Mitotane?
MediHelp rates the interaction as major. Levonorgestrel 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 potent enzyme inducer whose effect persists for weeks to months after stopping. It can substantially reduce levonorgestrel exposure and so compromise contraceptive efficacy, especially for oral and emergency use.
How serious is the interaction between Levonorgestrel 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 method such as a copper IUD or barrier contraception, and continue it for an extended period after stopping mitotane. For emergency contraception, prefer a copper IUD.
What other medicines interact with Levonorgestrel?
MediHelp also lists interactions of Levonorgestrel with, for example, Amobarbital, Apalutamide, Belzutifan. The full list is on the 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.
