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Ethinyl estradiol and norgestimate is a combination oral contraceptive containing a synthetic estrogen (ethinyl estradiol) and a progestin (norgestimate), used primarily to prevent pregnancy and also indicated for the treatment of moderate acne in females who desire contraception. The mechanism of action involves suppression of ovulation by inhibiting gonadotropins, thickening cervical mucus to impede sperm penetration, and altering the endometrial lining to reduce the likelihood of implantation. Efavirenz is an antiretroviral drug (non-nucleoside reverse transcriptase inhibitor) used in HIV therapy. When coadministered with ethinyl estradiol/norgestimate, efavirenz significantly reduces plasma concentrations of the progestin component (norgestimate metabolites), potentially decreasing contraceptive efficacy; it does not significantly affect ethinyl estradiol levels. This combination is not recommended for reliable contraception due to this interaction[1][6][8].
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