Drug Interactions With Levonorgestrel-Releasing Intrauterine System

When the hormone in levonorgestrel-releasing intrauterine levonorgestrel system is taken in oral form, it can react with other drugs. However, it is not known if these same interactions apply to the levonorgestrel-releasing intrauterine system. Acitretin, St. John's wort, and bosentan are some of the drugs that might cause problems with this intrauterine device.

An Overview of Levonorgestrel-Releasing Intrauterine System Interactions

Levonorgestrel-releasing intrauterine system (Mirena®, Skyla™) is a type of intrauterine device (IUD) that works by releasing levonorgestrel, a progestin hormone, into the uterus. At this time, it is unknown whether the device interacts with other medications.
Levonorgestrel is a progestin hormone found in certain birth control pills. When taken by mouth, the hormone can interact with several other drugs. However, levonorgestrel intrauterine device is placed directly into the uterus. Thus, it is not known whether oral interactions also apply to intrauterine levonorgestrel. There are no interaction studies with the intrauterine device. 
Drugs that may interact with levonorgestrel-releasing intrauterine system may include but are not limited to:
  • Non-nucleoside reverse transcriptase inhibitor (NNRTI) HIV medications, such as:
    • Delavirdine (Rescriptor®)
    • Efavirenz (Sustiva®)
    • Nevirapine (Viramune®)
  • Protease inhibitors, such as:
    • Amprenavir (Agenerase®)
    • Atazanavir (Reyataz®)
    • Darunavir (Prezista®)
    • Fosamprenavir (Lexiva®)
    • Indinavir (Crixivan®)
    • Lopinavir and ritonavir (Kaletra®)
    • Nelfinavir (Viracept®)
    • Ritonavir (Norvir®)
    • Saquinavir (Fortovase®, Invirase®)
    • Tipranavir (Aptivus®)

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Last reviewed by: Kristi Monson, PharmD
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