ethinyl estradiol/norethindrone

7.2 Increase i n Plasma Levels of Ethinyl Estradiol Associated with Co-Administered Drugs Co-administration of atorvastatin and certain COCs containing ethinyl estradiol increase AUC values for ethinyl estradiol by approximately 20 percent.

Mechanism: Atorvastatin increases the amount of birth control hormone that stays in your blood. This happens because the statin changes how the body processes the hormone.

What to do: Your doctor may need to monitor you for side effects related to higher estrogen levels. No specific dose change is typically required for this minor interaction.

7.2 Increase i n Plasma Levels of Ethinyl Estradiol Associated with Co-Administered Drugs Co-administration of atorvastatin and certain COCs containing ethinyl estradiol increase AUC values for ethinyl estradiol by approximately 20 percent. Ascorbic acid and acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. 7.4 Changes in Plasma Levels of Co-Administered Drugs COCs containing some synthetic estrogens (for example, ethinyl estradiol) may inhibit the metabolism of other compounds.

Mechanism: Taking these two medications together can slow down how your body breaks down estrogen. This can cause the level of estrogen in your blood to rise.

What to do: Your healthcare provider may need to adjust your dosages to prevent side effects. Watch for symptoms like nausea or breast pain.

COCs have been shown to significantly decrease plasma concentrations of lamotrigine, likely due to induction of lamotrigine glucuronidation. This may reduce seizure control; therefore, dosage adjustments of lamotrigine may be necessary.

Mechanism: The birth control pill causes your body to break down the seizure medication much faster than usual. This can lower the amount of medicine in your blood and make it less effective.

What to do: Your doctor may need to increase your dose of the seizure medication. Closely monitor for any changes in seizure control.

John’s wort topiramate HIV protease inhibitors and non-nucleoside reverse transcriptase inhibitors : Significant changes (increase or decrease) in the plasma levels of the estrogen and progestin have been noted in some cases of co-administration of HIV protease inhibitors or of non-nucleoside reverse transcriptase inhibitors.

Mechanism: This medication can change the levels of birth control hormones in your body. It may cause the hormones to increase or decrease, which can affect how well the birth control works.

What to do: Your doctor may need to adjust your dose or suggest a backup method of birth control. Monitor for any breakthrough bleeding or changes in effectiveness.

Ascorbic acid and acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation.

Mechanism: Acetaminophen can interfere with how your body clears out birth control hormones. This leads to higher levels of the hormone staying in your bloodstream.

What to do: Be aware that you may experience more side effects from your birth control when taking these together. Consult your doctor if you use pain relievers frequently.