AdultPediatricDosage Forms & Strengths levonorgestrel/ethinyl estradiol tablet, monophasic (Aubra, Aviane, Delyla, Falmina, Falessa, Falessa Kit, Larissia, Lessina, Lutera, Orsythia, Vienva) Days 1-21: 0.1mg/20mcg Days 22-28: Inert tablets Days 22-28: folic acid 1 mg (Falessa Kit) tablet, monophasic (Altavera, Chateal, Kurvelo, Levora, Lillow, Marlissa, Nordette, Portia) Days 1-21: 0.15mg/30mcg Days 22-28: Inert tablets tablet, 91-day (Seasonale, Quasense, Introvale, Jolessa, Setlakin) Days 1-84: 0.15mg/30mcg Days 85-91: Inert tablets tablet, 91-day (Seasonique, Amethia, Ashlyna, Camrese, Daysee) Days 1-84: 0.15mg/30mcg Days 85-91: Ethinyl estradiol 10mcg tablet, 91-day (LoSeasonique, Amethia Lo, Camrese Lo) Days 1-84: 0.1mg/20mcg Days 85-91: Ethinyl estradiol 10mcg tablet, 91-day (Quartette, Fayosim, Rivelsa) Days 1-42: 0.15mg/20mcg Days 43-63: 0.15mg/25mcg Days 64-84: 0.15mg/30mcg Days 85-91: Ethinyl estradiol 10mcg tablet, triphasic (Elifemme, Enpresse, Levonest, Trivora 28) Days 1-6: 0.05mg/30mcg Days 7-11: 0.075mg/40mcg Days 12-21: 0.125mg/30mcg Days 22-28: Inert tablets tablet, continuous cycle 0.09mg/20mcg Contraception Monophasic 1 active tablet PO daily for 21 days, then 1 inert tablet PO daily for 7 days (follow manufacturer's color-coding for sequence) 91-day 1 combination tablet daily for 84 days, then either 1 inert tablet or 1 tablet of ethinyl estradiol 10 mcg for 7 days First cycle begins on first Sunday after onset of menstruation; if menstruation begins on Sunday, first combination tablet is taken that day, with subsequent tablets taken in order specified on dispenser Use nonhormonal backup method of contraception (eg, condoms and spermicide) for first 7 days of treatment Next and all subsequent 91-day courses of tablets are initiated without interruption on same day of the week (Sunday), following same schedule, with tablets taken at same time of day on each day of active treatment Triphasic Regimens vary; see package inserts (follow manufacturer's color-coding for sequence) Continuous cycle 1 tablet PO daily at same time each day, with no tablet-free interval Missed Active Contraceptive Dose One active tablet missed Take 1 tablet as soon as possible, or take 2 tablets on following day Alternatively, take 1 tablet, discard missed tablet, and continue taking subsequent tablets as scheduled Use other forms of contraception for next 7 days after missed dose or until menses occur Two active tablets missed consecutively Take 2 tablets as soon as remembered and continue taking as scheduled Alternatively, take 2 tablets daily for the next 2 days and continue taking as scheduled Missed 3rd week of cycle and patient is Sunday Starter: Take 1 pill every day until Sunday; discard rest of pack, and start new pack that same day Missed 3rd week of cycle and patient is day-1 starter: Discard rest of pack, and start new pack that same day Use other forms of contraception for next 7 days after missed dose or until menses occur Menses may not occur this month; if menses do not occur for 2 consecutive months, contact healthcare provider about possibility of pregnancy Three active tablets missed consecutively Sunday starter: Take 1 pill every day until Sunday; discard rest of pack, and start new pack that same day Day-1 starter: Discard rest of pack, and start new pack that same day Use other forms of contraception for next 7 days after missed dose or until menses occur Menses may not occur this month; if menses do not occur for 2 consecutive months, contact healthcare provider about possibility of pregnancy Dosing Considerations Post pregnancy Increased risk of venous thromboembolism (VTE) after delivery with combined hormonal contraceptives; risk declines rapidly after 21 days but does not return to normal until 42 days after delivery Centers for Disease Control and Prevention (CDC) guidelines recommend waiting 3-6 weeks to initiate oral contraception in postpartum women without additional VTE risks After vaginal birth: Wait ≥3 weeks before initiating oral contraception After cesarean section birth: Wait ≥6 weeks before initiating oral contraception Women with other risk factors for VTE in addition to postpartum: Do not use combined hormonal contraceptives Presence of other VTE risk factors in addition to postpartum status: Do not use combined hormonal contraceptives Dosing Modifications Renal impairment: Use with caution Hepatic impairment: Do not administerSafety and efficacy are expected to be the same in postpubertal adolescents aged <16 years and users aged >16 years Use before menarche is not indicatedInteraction CheckerEnter a drug name and levonorgestrel oral/ethinyl estradiolNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (3)fezolinetantethinylestradiol will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC), ethinylestradiol. unspecified interaction mechanism. Contraindicated. Potential for increased ALT; contraceptive failure may occur when coadministered with protease inhibitors (ritonavir).ethinylestradiol, ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC). Either increases toxicity of the other by unspecified interaction mechanism. Contraindicated. ALT elevations >5 x ULN (including some >20 x ULN) observed in clinical trials when ethinyl estradiol was coadministered with ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. Discontinue ethinyl estradiol-containing medications before initiating ombitasvir/paritaprevir/ritonavir, and/or dasabuvir. Restart ethinyl estradiol containing medication ~2 weeks after hepatitis C combination drug regimen completed.tranexamic acid oraltranexamic acid oral, ethinylestradiol. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated. Coadministration of tranexamic acid oral and combination hormonal contraceptives increases thrombotic risk.Serious - Use Alternative (84)abametapirabametapir will increase the level or effect of levonorgestrel oral by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abametapir will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.amobarbitalamobarbital will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.antithrombin IIIlevonorgestrel oral, antithrombin III. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.antithrombin alfalevonorgestrel oral, antithrombin alfa. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.anastrozoleethinylestradiol decreases effects of anastrozole by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Anastrozole should not be given concurrently with any estrogens or estrogen-containing products.apalutamideapalutamide will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apalutamide will decrease the level or effect of levonorgestrel oral by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.argatrobanlevonorgestrel oral, argatroban. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.armodafinilarmodafinil will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.atazanaviratazanavir, ethinylestradiol. Other (see comment). Avoid or Use Alternate Drug. Comment: Significant changes (increase or decrease) can occur in estrogen plasma levels. Efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended. .belzutifanbelzutifan will decrease the level or effect of levonorgestrel oral by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Advise females of reproductive potential to use effective nonhormonal contraception. Based on animal studies, belzutifan can cause fetal harm.belzutifan will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of belzutifan with hormonal contraceptives may lead to contraceptive failure or increased breakthrough bleeding. Advise females of reproductive potential to use effective nonhormonal contraception. Based on animal studies, belzutifan can cause fetal harm.bemiparinlevonorgestrel oral, bemiparin. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.bosentanbosentan will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.bivalirudinlevonorgestrel oral, bivalirudin. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.brigatinibbrigatinib will decrease the level or effect of levonorgestrel oral by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Brigatinib induces CYP3A4 in vitro. Coadministration of hormonal contraceptives with brigatinib can result in decreased concentrations and loss of efficacy. Brigatinib can cause fetal harm. Women should use an effective nonhormonal method of contraception during treatment and for at least 4 months after the last brigatinib dose.brigatinib will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Brigatinib induces CYP3A4 in vitro. Coadministration of hormonal contraceptives with brigatinib can result in decreased concentrations and loss of efficacy. Brigatinib can cause fetal harm. Women should use an effective nonhormonal method of contraception during treatment and for at least 4 months after the last brigatinib dose.butabarbitalbutabarbital will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.calaspargase pegolcalaspargase pegol, levonorgestrel oral. unknown mechanism. Avoid or Use Alternate Drug. Due to the potential for an indirect interaction between calaspargase pegol and oral contraceptives, concomitant use of these drugs is not recommended. Use another non-oral contraceptive method for females of childbearing potential.calaspargase pegolcalaspargase pegol, ethinylestradiol. unknown mechanism. Avoid or Use Alternate Drug. Due to the potential for an indirect interaction between calaspargase pegol and oral contraceptives, concomitant use of these drugs is not recommended. Use another non-oral contraceptive method for females of childbearing potential.carbamazepineethinylestradiol will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.carbamazepine will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.conivaptanconivaptan will increase the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.dalteparinlevonorgestrel oral, dalteparin. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.dexamethasonedexamethasone will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.efavirenzefavirenz will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. The efficacy of hormonal contraceptives may be reduced. Use of a nonhormonal contraceptive is recommended.elagolixlevonorgestrel oral decreases effects of elagolix by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Based on the mechanism of action of elagolix, estrogen-containing contraceptives are expected to reduce elagolix efficacy. Effects of progestin-only contraceptives on the efficacy of elagolix is unknown. Advise women to use nonhormonal contraceptives during treatment with elagolix and for 1 week after discontinuing elagolix.ethinylestradiol decreases effects of elagolix by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Based on the mechanism of action of elagolix, estrogen-containing contraceptives are expected to reduce elagolix efficacy. Effects of progestin-only contraceptives on the efficacy of elagolix is unknown. Advise women to use nonhormonal contraceptives during treatment with elagolix and for 1 week after discontinuing elagolix.elvitegravirelvitegravir will decrease the level or effect of ethinylestradiol by unknown mechanism. Avoid or Use Alternate Drug. Consider alternative nonhormonal methods of contraception to add or replace combination oral contraceptiveenoxaparinlevonorgestrel oral, enoxaparin. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.encorafenibencorafenib will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme