Zolmitriptan and Levonorgestrel: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Zolmitriptan
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
An increased risk of zolmitriptan adverse effects
Interaction Deep Dive
In a retrospective analysis of pharmacokinetic data, the mean plasma concentrations of zolmitriptan were higher in females taking oral contraceptives compared with those not taking oral contraceptives. Specifically, the Cmax and AUC of zolmitriptan were 30% and 50% higher, respectively, and the time to maximum concentration (Tmax) was prolonged by one-half hour. The effect that zolmitriptan may have on the pharmacokinetics of oral contraceptives has not been evaluated1.
Why it happens (mechanism)
Inhibition of zolmitriptan metabolism
Common questions
Can I take Zolmitriptan and Levonorgestrel together?
An increased risk of zolmitriptan adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Zolmitriptan 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Zolmitriptan 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: Zomig(TM), zolmitriptan. AstrZeneca Pharmaceuticals LP, Wilmington, DE, 2003. DailyMed
Keep reading about Zolmitriptan
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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