Decreased effectiveness w/ CYP3A4-inducing drugs or herbal products. Increased plasma ethinyl estradiol levels w/ acetaminophen, ascorbic acid, CYP3A4 inhibitors (eg, itraconazole, ketoconazole, voriconazole, fluconazole, grapefruit juice), etoricoxib, HIV PIs (eg, atazanavir, indinavir), HMG-CoA reductase inhibitors (eg, atorvastatin, rosuvastatin), some NNRTIs (eg, etravirine). Increased plasma levels of cyclosporine, omeprazole, prednisolone, selegiline, theophylline, tizanidine, voriconazole. Decreased plasma levels of acetaminophen, clofibric acid, lamotrigine, morphine, salicylic acid, temazepam. Increased risk of ALT elevations w/ ombitasvir/paritaprevir/ritonavir & dasabuvir w/ or w/o ribavirin.