ethinyl estradiol/norgestimate

Co-administration of Iclevia and glecaprevir/pibrentasvir is not recommended due to potential for ALT elevations.

Mechanism: Combining these drugs can lead to an increase in liver enzymes, which may indicate liver damage. Because of this risk, the two drugs should not be used together.

What to do: This combination is not recommended. Ask your doctor for a different treatment option to protect your liver.

Substances increasing the systemic exposure of COCs: Co-administration of atorvastatin or rosuvastatin and certain COCs containing ethinyl estradiol (EE) increase AUC values for EE by approximately 20 to 25%.

Mechanism: Atorvastatin increases the amount of birth control hormone in your blood by changing how your body handles the medicine.

What to do: Your healthcare provider may need to monitor you for side effects or adjust your dosages.

Substances increasing the systemic exposure of COCs: Co-administration of atorvastatin or rosuvastatin and certain COCs containing ethinyl estradiol (EE) increase AUC values for EE by approximately 20 to 25%.

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

What to do: Your doctor may need to monitor you for increased side effects from the birth control. You should report any unusual symptoms to your healthcare provider.

No drug-drug interaction studies were conducted with levonorgestrel and ethinyl estradiol tablets. ( 7.1 ) 7.1 Effects of Other Drugs on Combined Oral Contraceptives Substances decreasing the plasma concentrations of COCs and potentially diminishing the efficacy of COCs: Table 5 includes substances that demonstrated an important drug interaction with levonorgestrel and ethinyl estradiol tablets. Colesevelam Clinical effect Concomitant use of COCs with colesevelam significantly decreases systemic exposure of ethinyl estradiol [see Clinical Pharmacology (12.3) ] .

Mechanism: Colesevelam can trap the birth control hormones in your gut and stop them from being absorbed into your body. This can make your birth control less effective at preventing pregnancy.

What to do: Take your birth control at least 4 hours before taking colesevelam to make sure it works correctly. Talk to your doctor about the best schedule for your medications.

Table 6: Significant Drug Interaction Information for Drugs Co-Administered With COCs Lamotrigine Clinical effect Concomitant use of COCs with lamotrigine may significantly decrease systemic exposure of lamotrigine due to induction of lamotrigine glucuronidation [See Clinical Pharmacology (12.3) ] . Decreased systemic exposure of lamotrigine may reduce seizure control. Consult the approved product labeling for lamotrigine.

Mechanism: The birth control pill causes your body to break down the seizure medicine lamotrigine much faster than usual. This can lower the amount of medicine in your blood and may lead to more seizures.

What to do: Your doctor may need to increase your dose of lamotrigine to keep your seizures under control. Tell your doctor immediately if you notice any changes in your seizure frequency.