Acitretin and Levonorgestrel: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acitretin
Levonorgestrel
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Loss of contraceptive effectiveness
Interaction Deep Dive
Acitretin interferes with the contraceptive effect of preparations containing microdose progestins; use of progestin "minipill" is not recommended with acitretin. Women on acitretin therapy should not rely on progestin-only contraceptives as one of their two forms of reliable birth control. It is not known whether acitretin also interferes with injectable or implantable progestational contraceptives, but caution should be utilized if these products are used1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Concomitant use of acitretin and combination contraceptives (levonorgestrel 0.15 to 0.5 mg plus ethinyl estradiol 0.03 to 0.05 mg) was reported to result in no interference of the antiovulatory activity of the contraceptive, even after prolonged use. However, failure of contraception was suspected in a patient receiving acitretin and a low-dose progestin contraceptive (levonorgestrel 0.03 mg) 2. It is recommended that acitretin patients avoid very low dose progestin contraceptive agents 1.
Common questions
Can I take Acitretin and Levonorgestrel together?
Loss of contraceptive effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acitretin and Levonorgestrel interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Acitretin or Levonorgestrel need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Product Information: SORIATANE(R) oral capsules, acitretin oral capsules. Stiefel Laboratories, Coral Gables, FL, 2007. DailyMed
- Berbis PH, Bun H, Geiger JM, et al: Acitretin (RO 10-1670) and oral contraceptives: interaction study. Arch Dermatol Res 1988a; 280:388-389.
Keep reading about Acitretin
Keep reading about Levonorgestrel
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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