How do oral contraceptives and protease inhibitors (PIs) interact?

Updated: Jan 15, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michelle R Salvaggio, MD, FACP  more...
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Answer

Answer

Oral contraceptives (OC) containing progestins other than norethindrone or norgestimate have not been studied; OC should contain at least 35 mcg of ethinyl estradiol.

RTV-boosted PIs can decrease ethinyl estradiol and norethindrone drug concentrations; use alternative or additional method.

ATV increases AUC of ethinyl estradiol and norethindrone; OC should contain no more than 30 mcg of ethinyl estradiol, or use alternative method; OC containing < 25 mcg of ethinyl estradiol or progestins other than norethindrone or norgestimate have not been studied.

FPV with amprenavir (APV) increases drug concentrations of ethinyl estradiol and norethindrone; possible decreases in APV drug concentration by 20%; recommendation is to use alternative method.


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