التداخل بين ميتابيفات ونوريثيستيرون وإيثينيل إستراديول

Counsel patients to use a back-up method or alternative method of contraception when enzyme inducers are used with COCs ( 7.1 ) -- - ---------- ------ USE IN SPECIFIC POPULATIONS---- -- -- --------- ---- Lactation: Not recommended; Lo Loestrin Fe can decrease milk production ( 8.2 )

Sensitive CYP3A substrates including hormonal contraceptives: Avoid concomitant use with substrates that have narrow therapeutic index.

Avoid concomitant use with hormonal contraceptives except for intrauterine systems containing levonorgestrel.

Co-administration of AQVESME will decrease systemic concentrations of drugs that are sensitive CYP3A substrates, including hormonal contraceptives (e.g., ethinyl estradiol) [see Clinical Pharmacology (12.3) ] .

If contraception is desired or needed, use an alternative contraceptive that is not affected by enzyme inducers.