What the FDA labels say about taking them together
Aprepitant and ethinyl estradiol/levonorgestrel
Ethinyl estradiol/levonorgestrel's FDA label of August 27, 2026 names aprepitant in its drug interactions section; the aprepitant labels PlainMeds reads (3) do not name ethinyl estradiol/levonorgestrel. The ethinyl estradiol/levonorgestrel label: “… griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John’s wort.”
Check it at the source: the aprepitant FDA label on DailyMed (effective July 5, 2024, Merck Sharp & Dohme LLC); the ethinyl estradiol/levonorgestrel FDA label on DailyMed (effective August 27, 2026, Exeltis USA, Inc.).
What does the aprepitant label say about ethinyl estradiol/levonorgestrel?
Aprepitant's label (effective July 5, 2024) and its 2 other brand-application labels do not name ethinyl estradiol/levonorgestrel in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (EMEND), NDA021549 (Msd), as published by Merck Sharp & Dohme LLC, effective July 5, 2024 (SPL set 696f9e80-9cae-403b-de9e-078343ce4713), via openFDA; the full label on DailyMed
What does the ethinyl estradiol/levonorgestrel label say about aprepitant?
Ethinyl estradiol/levonorgestrel label, drug interactionsContinue backup contraception for 28 days after discontinuing the enzyme inducer to maintain contraceptive reliability. Examples Aprepitant, barbiturates, bosentan, carbamazepine, efavirenz, felbamate, griseofulvin, oxcarbazepine, phenytoin, rifampin, primidone, phenylbutazone, rifabutin, rufinamide, topiramate, products containing St. John's wort, and certain protease inhibitors (see separate section on protease inhibitors below).
Balcoltra label (Avion Pharmaceuticals, December 5, 2025), drug interactionsSome drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. John’s wort.
Source: FDA drug label (Balcoltra, NDA208612), Avion Pharmaceuticals, effective December 5, 2025 (SPL set 752ab698-4b48-4614-8016-d1d33ee7c007), via openFDA
Source: FDA drug label (Twirla, NDA204017), Agile Therapeutics, Inc., effective June 30, 2026 (SPL set bcaf8db0-1750-425d-b008-255b5e7a9cc6), via openFDA
Source: FDA drug label (Tyblume), Exeltis USA, Inc., effective August 27, 2026 (SPL set b2482d51-d606-4aaa-8af4-19e4fe2f8872), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Aprepitant | Ethinyl estradiol/levonorgestrel | |
|---|---|---|
| Labeled for | Nausea and vomiting | Birth control |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $46.42 per capsule 40 mg capsule | $0.154 per tablet 28 tablet |
| Shortage now | A presentation being discontinued | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once