Lo Loestrin Fe (norethindrone acetate/ethinyl estradiol/ferrous fumarate) has potential interactions with other medications and some supplements. For example, Lo Loestrin Fe can interact with carbamazepine (Tegretol, others), melatonin, and St. John’s wort.
Lo Loestrin Fe is used to help prevent pregnancy in females of any age who are able to become pregnant.
The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Lo Loestrin Fe’s possible interactions. For a detailed overview of this drug, check out this in-depth Lo Loestrin Fe article.
Before you start taking Lo Loestrin Fe, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
The following table lists drugs that may interact with Lo Loestrin Fe. Keep in mind that this table does not include all drugs that may interact with Lo Loestrin Fe. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
| certain seizure medications | • carbamazepine (Tegretol, others) • phenobarbital (Sezaby) • phenytoin (Dilantin, Phenytek) • others | can make Lo Loestrin Fe less effective |
| certain antifungals | • griseofulvin (Fulvicin, Gris-PEG) • itraconazole (Sporanox, Tolsura) • ketoconazole | can make Lo Loestrin Fe less effective or increase the risk of its side effects |
| certain HIV medications | • atazanavir (Reyataz) • efavirenz • etravirine (Intelence) | can make Lo Loestrin Fe less effective or increase the risk of its side effects |
| certain antibiotics | • rifabutin (Mycobutin) • rifampin (Rifadin, Rimactane) • rifapentine (Priftin) • others | • can make Lo Loestrin Fe less effective • can make the antibiotic less effective in certain situations |
| acetaminophen (Tylenol) | — | can increase the risk of side effects from Lo Loestrin Fe |
| atorvastatin (Lipitor) | — | can increase the risk of side effects from Lo Loestrin Fe |
| bosentan (Tracleer) | — | can make Lo Loestrin Fe less effective |
| lamotrigine (Lamictal) | — | can make lamotrigine less effective |
| modafinil (Provigil) | — | can make Lo Loestrin Fe less effective |
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
To learn whether Lo Loestrin Fe interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Lo Loestrin Fe?” section.
Certain health conditions or other factors could raise your risk of harm if you take Lo Loestrin Fe. If this applies to you, your doctor may not prescribe Lo Loestrin Fe. These are known as contraindications. Lo Loestrin Fe has several contraindications, which are described here.
High risk of blood clots: If you have a high risk of blood clots, your doctor likely won’t prescribe Lo Loestrin Fe for you. This is because taking the medication could further increase your risk of blood clots. Factors with a high risk of blood clots include:
- age over 35 years and smoke (See the boxed warning about this at the top of this article.)
- history of blood clots, such as deep vein thrombosis (DVT) (clot in a deep vein) or pulmonary embolism (PE) (clot in a lung)
- past heart attack or stroke
- certain heart valve disorders
- atrial fibrillation
- certain blood clotting disorders
- high blood pressure that’s not well managed
- migraine with aura (disturbances in some senses)
- diabetes with complications affecting your blood vessels
If any of these factors apply to you, talk with your doctor about other forms of birth control that may be safer for you.
A history of breast cancer: If you have or ever had breast cancer, your doctor likely won’t prescribe Lo Loestrin Fe for you. This is because taking the medication could worsen your breast cancer or increase the risk of it coming back. Talk with your doctor about other forms of birth control that may be better options for you.
A liver tumor or liver disease: If you have a liver tumor or liver disease, your doctor likely won’t prescribe Lo Loestrin Fe for you. This is because your liver problem could cause Lo Loestrin Fe to build up in your body. This buildup can raise your risk of side effects from the drug. Taking Lo Loestrin Fe could also worsen your liver condition. Talk with your doctor about other forms of birth control that may be better options for you.
Unusual vaginal bleeding: If you have unusual, undiagnosed vaginal bleeding, your doctor likely won’t prescribe Lo Loestrin Fe for you. This is because taking the medication could cause changes to your periods. These changes could make it harder for your doctor to diagnose the cause of any unusual vaginal bleeding.
Allergic reaction: If you’ve had an allergic reaction to Lo Loestrin Fe or any of its ingredients, your doctor likely won’t prescribe Lo Loestrin Fe for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start taking Lo Loestrin Fe, talk with your doctor if any of the factors mentioned here apply to you. Your doctor can determine whether Lo Loestrin Fe is safe for you to take.
Read about Lo Loestrin Fe’s side effects in this article.
Lo Loestrin Fe is not known to interact with alcohol.
If you have questions about consuming alcohol while taking Lo Loestrin Fe, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Lo Loestrin Fe.
Interaction with certain seizure medications
Certain seizure medications can speed up the action of a certain enzyme in your body. This enzyme helps break down the hormones in Lo Loestrin Fe. Taking Lo Loestrin Fe with one of these medications can make your body break down Lo Loestrin Fe faster than usual. This can make it less effective at preventing pregnancy.
Some seizure medications that can interact with Lo Loestrin Fe are:
- carbamazepine (Tegretol, others)
- phenobarbital (Sezaby)
- phenytoin (Dilantin, Phenytek)
- felbamate (Felbatol)
- oxcarbazepine (Trileptal)
- topiramate (Topamax)
What you can do
If you take one of these seizure medications, your doctor likely won’t prescribe Lo Loestrin Fe. Instead, they’ll likely recommend that you use a different form of birth control that’s not affected by your seizure medication. You can talk with your doctor about your options.
If you take Lo Loestrin Fe with one of these seizure medications, you should use an extra method of birth control, such as condoms. You should use this extra method for as long as you take the medications together. If you stop taking the seizure medication, you should keep using the extra method of birth control for an additional 4 weeks.
If you have questions about taking Lo Loestrin Fe with seizure medications, talk with your doctor or pharmacist.
Interaction with certain antibiotics
Lo Loestrin Fe can interact with certain antibiotics, which are used to treat bacterial infections.
Certain antibiotics can speed up the action of an enzyme in your body that helps break down the hormones in Lo Loestrin Fe. Taking Lo Loestrin Fe with one of these antibiotics can make your body break down Lo Loestrin Fe faster than usual. This can make it less effective at preventing pregnancy.
Some antibiotics that can make Lo Loestrin Fe less effective are:
- rifabutin (Mycobutin)
- rifampin (Rifadin, Rimactane)
- rifapentine (Priftin)
Antibiotics that interact with iron: Each pack of Lo Loestrin Fe contains two brown pills that contain iron. Certain other antibiotics can interact with iron. Taking iron at the same time as these antibiotics can stop your body from absorbing the antibiotic correctly. This can make the antibiotic less effective.
Some antibiotics that can interact with the brown iron tablets in Lo Loestrin Fe are:
- ciprofloxacin (Cipro)
- doxycycline
- tetracycline
Antibiotics and vomiting or diarrhea: Note that most commonly prescribed antibiotics usually don’t affect hormonal birth control such as Lo Loestrin Fe. But antibiotics can sometimes cause vomiting or diarrhea.
If you have vomiting or diarrhea within 3 to 4 hours of taking a Lo Loestrin Fe pill, this can stop your body from absorbing the medication correctly. And this can make Lo Loestrin Fe less effective at preventing pregnancy.
What you can do
If you take rifabutin, rifampin, or rifapentine, your doctor will likely recommend that you don’t take Lo Loestrin Fe. Instead, they’ll likely recommend using a different form of birth control that’s not affected by the antibiotic. You can talk with your doctor about your options.
If you do take one of these antibiotics with Lo Loestrin Fe, you should use an extra method of birth control, such as condoms. You should continue using this extra method for as long as you take the medications together. When you stop the antibiotic, you should keep using the additional method of birth control for an additional 4 weeks.
Antibiotics that interact with iron: If you take an antibiotic that interacts with iron, remember that your brown Lo Loestrin Fe pills can interact with the antibiotic. You should avoid taking these pills within 2 hours of taking a dose of the antibiotic. If you’re not sure when to take your doses, talk with your doctor or pharmacist.
Antibiotics and vomiting or diarrhea: If you take any antibiotic that makes you vomit or have diarrhea within 3 to 4 hours of taking a Lo Loestrin Fe pill, be sure to follow the “Missed Dose” instructions in the Lo Loestrin Fe medication guide.
Talk with your doctor or pharmacist if you have questions about taking Lo Loestrin Fe with antibiotics.
Interaction with acetaminophen (Tylenol)
Lo Loestrin Fe might interact with the pain reliever acetaminophen (Tylenol).
Taking acetaminophen with Lo Loestrin Fe might prevent your body from breaking down ethinyl estradiol as well as usual. (Ethinyl estradiol is one of the ingredients in Lo Loestrin Fe.) So taking acetaminophen might raise your risk of side effects from Lo Loestrin Fe. These include:
- headache
- nausea
- breast tenderness
What you can do
It’s usually considered safe to take acetaminophen with Lo Loestrin Fe, as this interaction is usually minor.
If you do take acetaminophen with Lo Loestrin Fe, tell your doctor if you have new or increased side effects.
Talk with your doctor or pharmacist if you have questions about taking Lo Loestrin Fe with acetaminophen.
Read about Lo Loestrin Fe’s side effects in this article.
Lo Loestrin Fe may have other interactions. They could occur with supplements, foods, vaccines, or lab tests.
Note that the following discussion does not include all other interactions possible with Lo Loestrin Fe.
Does Lo Loestrin Fe interact with supplements?
Before you start taking Lo Loestrin Fe, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
For example, Lo Loestrin Fe may interact with melatonin supplements, which some people use to help with sleep. Lo Loestrin Fe may increase the level of melatonin in your body. The National Health Service (NHS) in the United Kingdom indicates that taking melatonin supplements with Lo Loestrin Fe increases the risk of melatonin’s side effects. Examples include headaches and daytime sleepiness.
Talk with your doctor or pharmacist if you have questions about interactions that may affect you.
Lo Loestrin Fe interactions with herbs
Lo Loestrin Fe can interact with St. John’s wort, which some people use to help treat depression and other conditions.
Taking St. John’s wort with Lo Loestrin Fe can make your body break down the hormones in Lo Loestrin Fe faster than usual. This can make Lo Loestrin Fe less effective at preventing pregnancy. Your doctor will likely recommend that you don’t take St. John’s wort with Lo Loestrin Fe.
Lo Loestrin Fe interactions with vitamins
Taking Lo Loestrin Fe with vitamin C (ascorbic acid) might increase the amount of ethinyl estradiol that your body absorbs. (Ethinyl estradiol is one of the ingredients in Lo Loestrin Fe.) This might increase the risk of side effects from Lo Loestrin Fe.
You should check with your doctor or pharmacist before taking vitamin products with Lo Loestrin Fe.
Does Lo Loestrin Fe interact with food?
Lo Loestrin Fe currently has no reports of interacting with food. If you have questions about eating certain foods during your treatment with Lo Loestrin Fe, talk with your doctor.
Does Lo Loestrin Fe interact with vaccines?
Lo Loestrin Fe currently has no reports that it interacts with vaccines. If you have questions about getting certain vaccines during your Lo Loestrin Fe treatment, talk with your doctor.
Does Lo Loestrin Fe interact with lab tests?
Lo Loestrin Fe might affect the results of certain lab tests. Examples include:
- clotting factors (to check blood clotting ability)
- lipids (to check fats, such as cholesterol)
- glucose tolerance (to help diagnose diabetes)
If you have questions about having certain lab tests during your treatment with Lo Loestrin Fe, talk with the healthcare professional ordering the test.
Does Lo Loestrin Fe interact with cannabis or CBD?Lo Loestrin Fe currently has no reports that it interacts with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Lo Loestrin Fe.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Lo Loestrin Fe. Before taking Lo Loestrin Fe, talk with your doctor about your health history. They’ll determine whether Lo Loestrin Fe is right for you.
Health conditions or other factors that might interact with Lo Loestrin Fe include:
Body mass index (BMI): BMI is a measurement that estimates a person’s body fat based on their height and weight. It’s not known whether Lo Loestrin Fe will be effective at preventing pregnancy if you have a BMI of 35 or more. Talk with your doctor about other forms of birth control that may be better options for you.
Risk of blood clots: Lo Loestrin Fe can raise your risk of blood clots. These include deep vein thrombosis, pulmonary embolism, and clots that can cause a heart attack or stroke. If you already have a high risk of blood clots, your doctor likely won’t prescribe Lo Loestrin Fe. For more information, see the “When should I avoid Lo Loestrin Fe?” section. Also see the boxed warning at the top of this article.
High blood pressure: If you have high blood pressure, you may have a raised risk of blood clots with Lo Loestrin Fe. Taking Lo Loestrin Fe could also increase your blood pressure further. Talk with your doctor about whether the medication is right for you. If your doctor prescribes Lo Loestrin Fe, they’ll likely check your blood pressure more often.
High cholesterol or triglycerides: If you have high cholesterol, you may have a raised risk of blood clots with Lo Loestrin Fe. Taking Lo Loestrin Fe could also increase your cholesterol or triglycerides further. Talk with your doctor about whether Lo Loestrin Fe is right for you. If your doctor prescribes the medication, they’ll likely check your cholesterol or triglycerides more often.
Diabetes: If you have diabetes, you may have a raised risk of blood clots with Lo Loestrin Fe. Taking Lo Loestrin Fe could also make your blood sugar harder to manage. Ask your doctor whether Lo Loestrin Fe is right for you.
Recent or upcoming surgery: If you’ve recently had major surgery, you may have a raised risk of blood clots with Lo Loestrin Fe. Your doctor likely won’t prescribe Lo Loestrin Fe until you’re fully recovered and able to move around as usual. Let your doctor know if you have any upcoming surgery. They may recommend stopping Lo Loestrin Fe before your surgery.
Unusual vaginal bleeding: If you have unusual, undiagnosed vaginal bleeding, your doctor likely won’t prescribe Lo Loestrin Fe. For more information, see the “When should I avoid Lo Loestrin Fe?” section.
Breast cancer: If you have or ever had breast cancer, your doctor likely won’t prescribe Lo Loestrin Fe. For more information, see the “When should I avoid Lo Loestrin Fe?” section.
Liver tumor or liver disease: If you have a liver tumor or liver disease, your doctor likely won’t prescribe Lo Loestrin Fe. For more information, see the “When should I avoid Lo Loestrin Fe?” section.
Depression: If you have a history of depression, Lo Loestrin Fe could worsen your depression. Talk with your doctor about whether Lo Loestrin Fe is right for you.
Pregnancy: Lo Loestrin Fe is used to help prevent pregnancy. You should not take it if you’re pregnant. If you think you could be pregnant while taking Lo Loestrin Fe, see your doctor.
Breastfeeding: Lo Loestrin Fe isn’t usually recommended while breastfeeding. It could reduce the amount of breast milk you produce. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your birth control options.
Allergic reaction: If you’ve had an allergic reaction to Lo Loestrin Fe or any of its ingredients, your doctor will likely not prescribe Lo Loestrin Fe. For more information, see the “When should I avoid Lo Loestrin Fe?” section.
Does Adderall have interactions with Lo Loestrin Fe?
Adderall is a medication that’s prescribed for attention deficit hyperactivity disorder (ADHD). No interactions have been reported between Adderall and Lo Loestrin Fe. It’s usually considered safe to take these medications together.
If you have questions about taking Adderall with Lo Loestrin Fe, talk with your doctor or pharmacist.
Does ibuprofen interact with Lo Loestrin Fe?
Ibuprofen (Advil, Motrin) is a pain reliever that reduces inflammation (swelling). Ibuprofen has not been reported to interact with Lo Loestrin Fe. It’s usually considered safe to take these medications together.
If you have questions about taking ibuprofen with Lo Loestrin Fe, ask your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Lo Loestrin Fe. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Lo Loestrin Fe treatment
It’s also important to understand Lo Loestrin Fe’s
If you did not get paperwork with Lo Loestrin Fe, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Lo Loestrin Fe exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.