What the FDA labels say about taking them together
Ethinyl estradiol/levonorgestrel and ketoconazole
Ethinyl estradiol/levonorgestrel's FDA label of August 27, 2026 names ketoconazole in its drug interactions section; the ketoconazole label PlainMeds reads does not name ethinyl estradiol/levonorgestrel. The ethinyl estradiol/levonorgestrel label: “CYP3A4 inhibitors, such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations.”
Check it at the source: the ethinyl estradiol/levonorgestrel FDA label on DailyMed (effective August 27, 2026, Exeltis USA, Inc.); the ketoconazole FDA label on DailyMed (effective January 28, 2026, E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC).
What does the ethinyl estradiol/levonorgestrel label say about ketoconazole?
Ethinyl estradiol/levonorgestrel label, drug interactionsCYP3A inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice The effect of grapefruit juice on CYP3A4 enzymes (e.g., strong vs. moderate inhibition) depends on its brand, concentration, and preparation. , or ketoconazole may increase systemic exposure of the estrogen and/or progestin component of CHCs.
Balcoltra label (Avion Pharmaceuticals, December 5, 2025), drug interactionsCYP3A4 inhibitors, such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations.
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
What does the ketoconazole label say about ethinyl estradiol/levonorgestrel?
Ketoconazole's label (effective January 28, 2026) does 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 (ketoconazole), E. Fougera & Co. a division of Fougera Pharmaceuticals, LLC, effective January 28, 2026 (SPL set cad7c647-34a9-4e4e-83b3-8d78e58f588f), 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
| Ethinyl estradiol/levonorgestrel | Ketoconazole | |
|---|---|---|
| Labeled for | Birth control | Fungal infections |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.154 per tablet 28 tablet | $0.249 per gram 2% cream |
| Shortage now | No current entry | 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