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Levonorgestrel with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Levonorgestrel (Levonorgestrel). Most antibiotics do not interfere meaningfully with Levonorgestrel at 1.5mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Synthetic progestin (emergency contraception) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Levonorgestrel at 1.5mg.

Practical guidance

According to the prescribing information for Levonorgestrel, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Levonorgestrel is co-administered. Adjusted 1.5mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Levonorgestrel during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Levonorgestrel is metabolised and may need a temporary 1.5mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Levonorgestrel regimen.

Will antibiotics make Levonorgestrel stop working?

Most antibiotics do not affect Levonorgestrel efficacy. Rifampicin and a few others can lower Levonorgestrel levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.