Miconazole and Ethinyl Estradiol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ethinyl Estradiol
No brand names on recordMiconazole
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
Increased exposure to ethinyl estradiol
Interaction Deep Dive
Systemic exposure to ethinyl estradiol and segesterone was increased when used concomitantly with oil-based miconazole vaginal suppositories, but not when used with miconazole water-based suppositories. Avoid concurrent use of oil-based miconazole vaginal suppositories, including the 1-day or 3-day regimens, with the ethinyl estradiol-segesterone vaginal system as interference with the long-term performance of the vaginal system may occur. However, water-based vaginal cream or oral therapy may be used concurrently with the vaginal system1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) Systemic exposure (AUC Day 8 to 21) of ethinyl estradiol was increased approximately 67% with administration of miconazole nitrate oil-based vaginal suppository 1200 mg on Day 8 of use of the combination ethinyl estradiol/segesterone acetate. Segesterone exposure was also increased on Day 8 to 9 (30%), Day 8 to 10 (32%), and Day 8 to 21 (19%). Ethinyl estradiol exposure was increased by 9% and 42% on Day 8 to 11 and Day 8 to 21, respectively, with miconazole nitrate 200-mg oil-based suppository administered on Day 8, 9, and 10 of use of combination ethinyl estradiol/segesterone acetate. No effect on ethinyl estradiol or segesterone was observed with use of water-based miconazole cream 1.
Common questions
Can I take Miconazole and Ethinyl Estradiol together?
Increased exposure to ethinyl estradiol Always confirm with your pharmacist or prescriber before making any change.
How serious is the Miconazole and Ethinyl Estradiol interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
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 Miconazole or Ethinyl Estradiol 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 (1)
- Product Information: ANNOVERA(TM) vaginal system, segesterone acetate ethinyl estradiol vaginal system. Population Council (per FDA), New York, NY, 2018.
Keep reading about Ethinyl Estradiol
Keep reading about Miconazole
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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