Drug interactions
Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate + Nevirapine
Severity: Major
Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate and Nevirapine: 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
Nevirapine can reduce circulating ethinylestradiol and levonorgestrel, lowering the contraceptive reliability of the combined pill. This increases the risk of unintended pregnancy.
What this interaction means in plain words
Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate and Nevirapine 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.
Why it happens
Nevirapine induces CYP3A4 and increases the hepatic metabolism of the contraceptive steroids.
What to do
Use a non-hormonal or other reliable method such as a copper IUD or DMPA instead. If a combined pill is kept, add barrier backup during use and for 28 days after stopping nevirapine.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate with Nevirapine?
MediHelp rates the interaction as major. Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate and Nevirapine 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. Nevirapine can reduce circulating ethinylestradiol and levonorgestrel, lowering the contraceptive reliability of the combined pill. This increases the risk of unintended pregnancy.
How serious is the interaction between Levonorgestrel oral / ethinylestradiol / ferrous bisglycinate and Nevirapine?
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 or other reliable method such as a copper IUD or DMPA instead. If a combined pill is kept, add barrier backup during use and for 28 days after stopping nevirapine.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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