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mavacamten will lower the extent or impact of ethinylestradiol by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Progestin and ethinyl estradiol are CYP3A4 substrates. Mavacamten might decrease systemic exposures of ethinyl estradiol and progestin, which can produce contraceptive failure or a rise in breakth