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Drug Interactions With Levonorgestrel-Releasing Intrauterine System

More Detail on Drug Interactions With Levonorgestrel-Releasing Intrauterine System

The following sections explain in detail the potentially negative interactions that may occur when the levonorgestrel-releasing intrauterine system is combined with any of the drugs listed above.
 
Acitretin
When taken with acitretin, progestin-only birth control pills could fail to prevent pregnancy. It is unknown if acitretin interacts with other forms of progestin-only birth control, such as levonorgestrel-releasing intrauterine system. However, there is a possibility that any progestin-only contraception could fail during acitretin treatment.
 
It is generally recommended that women of childbearing potential either abstain from sexual intercourse or use two reliable forms of birth control at least one month before starting acitretin, during treatment, and for at least three years after stopping the medication.
 
Aprepitant
Aprepitant can make hormonal contraceptives less effective. It is recommended that women of childbearing potential use nonhormonal forms of birth control during aprepitant treatment and for at least one month after the last dose is taken.
 
Bosentan
Bosentan can make hormonal contraceptives less effective. To reduce the risk for unwanted pregnancy, women of childbearing potential who are taking bosentan should use nonhormonal forms of birth control.
 
CYP 3A4 Inducer Medications
Certain enzymes in the liver known as CYP 3A4 enzymes help break down progestins, including levonorgestrel. Medications known as CYP 3A4 inducers can increase the activity of these enzymes. Thus, combining progestin-containing birth control with one of these drugs may decrease the level of progestins in your blood, potentially making the birth control less effective.
 
It is not clear whether this interaction applies to levonorgestrel-releasing intrauterine system. Although the device is primarily thought to work directly on the uterus, it is possible that a certain blood level of levonorgestrel is also needed for the medication to prevent pregnancy. It is probably safest to use a different form of birth control if you take a CYP 3A4 inducer.
 
CYP 3A4 Inhibitor Medications
Certain enzymes in the liver known as CYP 3A4 enzymes help break down progestins, including levonorgestrel. Medications known as CYP 3A4 inhibitors can decrease the activity of these enzymes and increase progestin blood levels. This could increase the risk for side effects. Talk to your healthcare provider about this potential interaction before using these drugs together.
 
Felbamate
Felbamate can decrease blood levels of progestin contraceptives, potentially making them less effective. Because levonorgestrel-releasing intrauterine system contains levonorgestrel, a progestin hormone, this interaction may apply to it. Your healthcare provider may recommend a different form of birth control if you take felbamate.
 
Griseofulvin
Griseofulvin can make hormonal forms of birth control less effective. It is generally recommended that women use a nonhormonal birth control method during griseofulvin treatment. Talk to your healthcare provider before using these drugs together.
 
Non-Nucleoside Reverse Transcriptase Inhibitors 
NNRTI medications can increase or decrease (depending on the specific NNRTI) blood levels of hormonal contraceptives. It is also important to note that hormonal forms of birth control, such as levonorgestrel-releasing intrauterine system, do not protect against the transmission of HIV or other sexually transmitted infections. If you are being treated with an NNRTI, talk to your healthcare provider before using levonorgestrel-releasing intrauterine system.
 
Protease Inhibitors
Protease inhibitors can increase or decrease (depending on the specific protease inhibitor) blood levels of hormonal contraceptives. It is also important to note that hormonal forms of birth control, such as levonorgestrel-releasing intrauterine system, do not protect against the transmission of HIV or other sexually transmitted infections. If you are being treated with a protease inhibitor, talk to your healthcare provider before using levonorgestrel-releasing intrauterine system.
 
Topiramate
Topiramate can decrease blood levels of levonorgestrel, potentially making it less effective. This interaction may apply to levonorgestrel-releasing intrauterine system. Therefore, you should talk to your healthcare provider before using these medications together.
 

More Headlines in Drug Interactions With Levonorgestrel-Releasing Intrauterine System

↶ An Overview of Levonorgestrel-Releasing Intrauterine System Interactions
‣ Final Thoughts
Last reviewed by: Kristi Monson, PharmD
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