ethinyl estradiol (contraceptive) + mavacamten

ALL FORMS: monitor cardiac fxn, incl. LVEF; if patient stable on ethinyl estradiol, start mavacamten at 5 mg qd; if adding short-term (<1wk) ethinyl estradiol to mavacamten, hold mavacamten until ethinyl estradiol D/C; if adding longer-term (>1wk) ethinyl estradiol, decr. mavacamten dose per pkg insert; do not start ethinyl estradiol if on mavacamten 2.5 mg qd; WITH NORETHINDRONE: use OK; WITH OTHER PROGESTOGENS: use additional non-hormonal or alternative contraception during and x4mo after mavacamten: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. ethinyl estradiol levels, contraceptive efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

levonorgestrel (contraceptive) + mavacamten

use additional non-hormonal or alternative contraception during and x4mo after mavacamten tx: combo may decr. levonorgestrel levels, contraceptive efficacy (hepatic metabolism induced)

ethinyl estradiol (contraceptive) + duloxetine

caution advised: combo may incr. duloxetine levels, risk of adverse effects (hepatic metabolism inhibited)