Levonorgestrel and ethinyl estradiol and Mitotane interaction

Levonorgestrel and ethinyl estradiol and Mitotane: 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 Mitotane (Lysodren) label · effective 2026-03-03

Major

Hormonal contraceptives: Avoid concomitant use with LYSODREN.

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Major

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

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Minor

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) ].

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From the Levonorgestrel and ethinyl estradiol (Tyblume) label · effective 2026-08-27

Moderate

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

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Moderate

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) ] .

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Minor

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

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Minor

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

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Minor

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

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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.