Efavirenz, lamivudin ve tenofovir ve Etonogestrel ve etinilestradiol etkileşimi

…ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir]) /HCV protease inhibitors (decrease [e.g., boceprevir and telaprevir]) or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g., etravirine]).

Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin concentrations.

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

Counsel women to use an alternative non-hormonal method of contraception or a back-up method when enzyme inducers are used with Etonogestrel/Ethinyl Estradiol Vaginal Ring, and to continue back-up non-hormonal contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability.

Decreased exposure of etonogestrel may be expected.

There have been postmarketing reports of contraceptive failure with etonogestrel in EFV-exposed patients.

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives.

Implant Etonogestrel ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives.