Levonorgestrel and ethinyl estradiol and Tobacco and smoking interaction
Levonorgestrel and ethinyl estradiol and Tobacco and smoking: the Levonorgestrel and ethinyl estradiol prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
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
WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use.
This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked.
WARNING: CIGARETTE SMOKING AND SERIOUS CARDIOVASCULAR EVENTS See full prescribing information for complete boxed warning .
Cigarette smoking increases the risk of serious cardiovascular side effects from combination hormonal contraceptive (CHC) use.
The risk is greater among older women (> 35 years of age), smokers, and females with hypertension, dyslipidemia, diabetes, or obesity.
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