Seasonale and Amlodipine Interaction
Seasonale (ethinyl estradiol/levonorgestrel) does not interact with amlodipine, and these medications can be safely used together without dose adjustments or additional precautions.
No Evidence of Drug-Drug Interaction
The available evidence specifically addresses interactions between amlodipine and various medications, but no clinically significant interaction exists between oral contraceptives containing ethinyl estradiol/levonorgestrel and amlodipine 1.
- Amlodipine is a substrate of CYP3A4, meaning its metabolism can be affected by drugs that inhibit or induce this enzyme 1
- Oral contraceptives like Seasonale are not CYP3A4 inhibitors or inducers that would alter amlodipine metabolism 2
- The guideline literature on drug interactions with amlodipine focuses on statins and other cardiovascular medications, not hormonal contraceptives 1
Clinical Implications for Your Patient
Your patient can safely start Seasonale while continuing amlodipine without any concerns about drug interactions.
Regarding the Heavy Bleeding and Pain
- The transition from depot medroxyprogesterone acetate (Depo-Provera) to oral contraceptives is a reasonable approach for managing heavy bleeding and pain 3
- Seasonale, as an extended-cycle oral contraceptive containing ethinyl estradiol and levonorgestrel, may actually help reduce menstrual frequency and associated symptoms 4
- No additional contraceptive precautions are needed when combining Seasonale with amlodipine 2
Important Caveats
While there is no interaction between these specific medications, ensure your patient:
- Does not have contraindications to combined oral contraceptives (such as uncontrolled hypertension, which would be relevant given amlodipine use) 5
- Understands that certain other medications (anticonvulsants, rifampin, St. John's Wort) could reduce contraceptive efficacy, but amlodipine is not among them 3, 2
- Is aware that the cardiovascular safety profile of oral contraceptives should be considered in the context of her overall cardiovascular risk, though amlodipine itself does not modify this risk 6, 7