Levonorgestrel and ethinyl estradiol and Mifepristone interaction

Levonorgestrel and ethinyl estradiol and Mifepristone: 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 Levonorgestrel and ethinyl estradiol (Tyblume) label · effective 2026-08-27

Major

…symptoms, migraine headaches with aura, or over age 35 with any migraine headaches [see Warnings and Precautions (5.7) ] Current or history of breast cancer or other estrogen- or progestin-sensitive cancer Liver tumors, acute viral hepatitis, or severe (decompensated) cirrhosis [see Warnings and Precautions (5.2) ] Undiagnosed abnormal uterine bleeding [see…

Contraindicationsby drug classView label on DailyMed
Major

Breast cancer or other estrogen- or progestin-sensitive cancer.

Contraindicationsby drug classView label on DailyMed
Moderate

CYP3A inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice The effect of grapefruit juice on CYP3A4 enzymes (e.g., strong vs. moderate inhibition) depends on its brand, concentration, and preparation. , or ketoconazole may increase systemic exposure of the estrogen and/or progestin component of CHCs.

Drug interactionsby drug classView label on DailyMed
Minor

Effects of Other Drugs on Combined Hormonal Contraceptives Substances decreasing the Plasma Concentration of CHCs and Potentially Diminishing the Efficacy of CHCs Table 3 Significant Drug Interactions Involving Substances That Affect CHCs a Induction potency of St.

Drug interactionsby drug classView label on DailyMed

From the Mifepristone label · effective 2025-09-25

Major

Hormonal contraceptives: Do not use with mifepristone ( 7.6 ).

Drug interactionsby drug classView label on DailyMed
Moderate

…study has been conducted to evaluate the effect of mifepristone on substrates of CYP2B6, the concomitant use of bupropion and efavirenz should be undertaken with caution. [See Clinical Pharmacology ( 12.3 )] 7.6 Use of Hormonal Contraceptives Mifepristone is a progesterone-receptor antagonist and will interfere with the effectiveness of hormonal contraceptives.

Drug interactionsby drug classView label on DailyMed
Minor

Therefore, non-hormonal contraceptive methods should be used. [See Use In Specific Populations ( 8.3 )]

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.