Conjugated estrogens and Norethindrone and ethinyl estradiol interaction

Conjugated estrogens and Norethindrone and ethinyl estradiol: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Conjugated estrogens (Premarin) label · effective 2025-05-30

Major

Adding a progestin to estrogen therapy has been shown to reduce the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer.

Boxed warningby drug classView label on DailyMed
Major

(See CLINICAL STUDIES and WARNINGS, Probable Dementia and PRECAUTIONS, Geriatric Use .) In the absence of comparable data, these risks should be assumed to be similar for other doses of CE and other dosage forms of estrogens.

Boxed warningby drug classView label on DailyMed
Major

Estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.

Boxed warningby drug classView label on DailyMed
Major

Estrogen Plus Progestin Therapy Cardiovascular Disorders and Probable Dementia Estrogen plus progestin therapy should not be used for the prevention of cardiovascular disease or dementia.

Boxed warningby drug classView label on DailyMed
Major

(See CLINICAL STUDIES and WARNINGS, Cardiovascular disorders and Probable Dementia .) The WHI estrogen plus progestin substudy reported increased risks of DVT, pulmonary embolism (PE), stroke and myocardial infarction (MI) in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral CE (0.625 mg) combined with medroxyprogesterone…

Boxed warningby drug classView label on DailyMed

From the Norethindrone and ethinyl estradiol (Lo Loestrin Fe) label · effective 2025-03-07

Minor

Changes in Contraceptive Effectiveness Associated with Co-Administration of Other Products If a woman on hormonal contraceptives takes a drug or herbal product that induces enzymes, including CYP3A4, that metabolize contraceptive hormones, counsel her to use additional contraception or a different method of contraception.

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.