التداخل بين ليفونورجيستريل وإيثينيل إستراديول وميتوتان

Hormonal contraceptives: Avoid concomitant use with LYSODREN.

Hormonal Contraceptives Avoid concomitant use of LYSODREN with hormonal contraceptives [see Warnings and Precautions (5.8) , Use in Specific Populations (8.3) ].

Advise females of reproductive potential to use effective nonhormonal contraception, during treatment with LYSODREN and after discontinuation of treatment for as long as mitotane plasma levels are detectable, since LYSODREN can render some hormonal contraceptives ineffective [see Drug Interactions (7.2) , Use in Specific Populations (8.1 , 8.3) ].

Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding.

Metabolic Enzyme Inducers Clinical effect Concomitant use of CHCs with metabolic enzyme inducers may decrease the plasma concentrations of the estrogen and/or progestin component of CHCs [see Clinical Pharmacology (12.3) ] .

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with TYBLUME.

Prevention or management Counsel females to use an alternative method of contraception or a backup method when enzyme inducers are used with CHCs.

Continue backup contraception for 28 days after discontinuing the enzyme inducer to maintain contraceptive reliability.