Perampanel and Levonorgestrel: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Perampanel
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
Decreased contraceptive effectiveness
Interaction Deep Dive
Contraceptive effectiveness may be reduced when hormonal contraceptives or implants containing levonorgestrel are used with perampanel. In studies of concurrent use of perampanel and oral contraceptives containing levonorgestrel, perampanel 4 mg/day and 8 mg/day did not alter levonorgestrel Cmax or AUC, but perampanel 12 mg/day, decreased levonorgestrel Cmax by 42% and AUC by 40%. Patients should be informed that perampanel may decrease the effectiveness of contraceptives or implants containing levonorgestrel, and should be counseled to use alternative non-hormonal forms of contraception1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) The AUC and Cmax of the levonorgestrel component of an oral contraceptive containing ethinyl estradiol 30 mcg and levonorgestrel 150 mcg were decreased by 40% and 42%, respectively, in healthy females receiving a single dose of the oral contraceptive after 21 days of perampanel 12 mg daily. Ethinyl estradiol AUC was not affected, but Cmax was decreased by 18%. No significant effect on levonorgestrel or ethinyl estradiol concentrations were seen in patients receiving perampanel 8 mg daily for 21 days who were given a single dose of the oral contraceptive. Additionally, AUC and Cmax of levonorgestrel and ethinyl estradiol were not affected by the coadministration of the oral contraceptive and perampanel 4 mg once daily for 21 days 1.
Common questions
Can I take Perampanel and Levonorgestrel together?
Decreased contraceptive effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Perampanel and Levonorgestrel 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 Perampanel 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 (1)
- Product Information: FYCOMPA(TM) oral tablets, perampanel oral tablets. Eisai Inc. (per Manufacturer), Woodcliff Lake, NJ, 2012. DailyMed
Keep reading about Perampanel
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist