Female patients of child-bearing potential should be advised to discuss contraceptive options with their health care provider to prevent unintended pregnancies. An alternative method or an additional method of contraception should be utilized during armodafinil therapy and continued for one month after armodafinil discontinuation.
Artemether; Lumefantrine: Major Although no formal drug interaction studies have been performed, the manufacturer states that artemether; lumefantrine may reduce the effectiveness of hormonal contraceptives, including non-oral combination contraceptives, oral contraceptives, and progestin contraceptives i. This may be due to a CYP3A4 interaction. Additional use of a non-hormonal method of birth control is recommended.
Major Although no formal drug interaction studies have been performed, the manufacturer states that artemether; lumefantrine may reduce the effectiveness of hormonal treatments, including progestin-only contraceptives e. Additional use of a non-hormonal method of birth control is recommended when norethindrone is used for birth control. Women receiving norethindrone hormone replacement or contraceptives with artemether; lumefantrine should be instructed to report any breakthrough bleeding or other adverse effects to their prescribers.
Atazanavir: Major Atazanavir may decrease the metabolism of oral contraceptives and non-oral combination contraceptives; the mean exposure and minimum serum concentrations of ethinyl estradiol and norethindrone are increased when administered with atazanavir mg daily. However, if atazanavir is boosted with ritonavir, mean exposure of ethinyl estradiol will be decreased; data are limited regarding use of atazanavir with cobicistat. Instruct women to report any breakthrough bleeding or other adverse effects e.
It may be prudent for women who receive hormonal contraceptives with atazanavir boosted with ritonavir or cobicistat to use an additional method of contraception to protect against unwanted pregnancy. Atazanavir; Cobicistat: Major Atazanavir may decrease the metabolism of oral contraceptives and non-oral combination contraceptives; the mean exposure and minimum serum concentrations of ethinyl estradiol and norethindrone are increased when administered with atazanavir mg daily. Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone.
Insufficient data are available to make dosage recommendations, particularly when cobicistat is combined in other antiviral regimens. It is not clear how cobicistat alters various progestin-only agents used for contraception, fertility or luteal support, or for hormone replacement therapy HRT.
There is a potential for altered efficacy for combined hormonal contraceptives. When progestins are used for other purposes, monitor for altered clinical response to hormonal therapy. Azithromycin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Aztreonam: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Bacitracin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Barbiturates: Moderate Barbiturates can accelerate the hepatic clearance of progestins. Belladonna Alkaloids; Ergotamine; Phenobarbital: Moderate Barbiturates can accelerate the hepatic clearance of progestins. Belzutifan: Major Women taking both progestins and belzutifan should report breakthrough bleeding to their prescribers.
An alternate or additional form of contraception should be considered in patients prescribed belzutifan. The alternative or additional contraceptive agent may need to be continued for 1 month after discontinuation of belzutifan. For patients on hormone replacement treatments HRT with progestins, monitor for altered clinical response, such as increased hot flashes, vaginal dryness, changes in withdrawal bleeding, or other signs of decreased hormonal efficacy. Bexarotene: Major Bexarotene capsules may theoretically increase the rate of metabolism and reduce plasma concentrations of substrates metabolized by CYP3A4, including oral contraceptives.
It is recommended that two reliable forms of contraception be used simultaneously during oral bexarotene therapy. It is strongly recommended that one of the forms of contraception be non-hormonal. Additionally, because of possible CYP3A4 induction, bexarotene may also decrease the efficacy of hormones used for hormone replacement therapy. Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Bismuth Subsalicylate; Metronidazole; Tetracycline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Instead, the manufacturer recommends use of contraceptives that contain ethinyl estradiol and at least 1 mg of norethindrone.
Boceprevir recipients and their partners are also required to use a second, non-hormonal, form of birth control while on therapy and for at least 6 months after treatment.
Bosentan: Major Hormonal contraceptives should not be used as the sole method to prevent pregnancy in patients receiving bosentan. Bosentan is teratogenic.
To prevent pregnancy, females of reproductive potential must use 2 acceptable contraception methods during treatment and for 1 month after discontinuation of bosentan therapy.
The patient may choose 1 highly effective contraceptive form, including an intrauterine device IUD or tubal sterilization, a combination of a hormonal contraceptive with a barrier method, or 2 barrier methods. If a male partner's vasectomy is chosen as a method of contraception, a hormonal or barrier method must still be used by the female patient.
Hormonal contraceptives, including oral contraceptives or non-oral combination contraceptives injectable, transdermal, and implantable contraceptives may not be reliably effective in the presence of bosentan, since many contraceptive drugs are metabolized by CYP3A4 isoenzymes and bosentan is a significant inducer of CYP3A enzymes.
Decreases in hormonal exposure have been documented in drug interaction studies of bosentan with hormonal contraception. Additionally, estrogens and progestins used for hormone replacement therapy HRT may also be less effective; patients should be monitored for changes in efficacy such as breakthrough bleeding or an increase in hot flashes.
Dosage adjustments may be necessary. Bromocriptine: Minor Bromocriptine is used to restore ovulation and ovarian function in amenorrheic women. Progestins can cause amenorrhea and, therefore, counteract the desired effects of bromocriptine. Concurrent use is not recommended; an alternate form of contraception is recommended during bromocriptine therapy. Butabarbital: Moderate Barbiturates can accelerate the hepatic clearance of progestins.
Butalbital; Acetaminophen: Moderate Barbiturates can accelerate the hepatic clearance of progestins. Butalbital; Acetaminophen; Caffeine: Moderate Barbiturates can accelerate the hepatic clearance of progestins. Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Barbiturates can accelerate the hepatic clearance of progestins. Calaspargase pegol: Major The concomitant use of calaspargase pegol and oral contraceptives may reduce the efficacy of oral contraceptives.
Women of reproductive potential should use a non-hormonal method of birth control during therapy and for at least 3 months after the last calaspargase pegol dose due to the risk of fetal harm. Canagliflozin: Minor Progestins can impair glucose tolerance. Canagliflozin; Metformin: Minor Patients receiving antidiabetic agents like metformin should be closely monitored for signs indicating changes in diabetic control when therapy with progestins is instituted or discontinued.
Carbamazepine: Major Concomitant use of carbamazepine with hormonal products may render the hormonal product less effective.
The plasma concentrations of the hormones may be decreased because carbamazepine induces the activity of hepatic metabolic enzymes. Women taking both hormones and hepatic enzyme-inducing drugs should report breakthrough bleeding to their prescribers. If used for contraception, an alternate or additional form of contraception should be considered in patients prescribed hepatic enzyme inducing drugs, or higher-dose hormonal regimens may be indicated where acceptable or applicable as pregnancy has been reported in patients taking the hepatic enzyme inducing drug phenytoin concurrently with hormonal contraceptives.
The alternative or additional contraceptive agent may need to be continued for 1 month after discontinuation of the interacting medication. Additionally, epileptic women taking both anticonvulsants and OCs may be at higher risk of folate deficiency secondary to additive effects on folate metabolism; if oral contraceptive failure occurs, the additive effects could potentially heighten the risk of neural tube defects in pregnancy.
Patients taking progestins for other indications may need to be monitored for reductions in clinical effect of the progestin. Carbapenems: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Carbenicillin: Moderate It was previously thought that antibiotics may decrease the effectiveness of oral contraceptives containing estrogens due to stimulation of estrogen metabolism or a reduction in estrogen enterohepatic circulation via changes in GI flora.
One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with oral contraceptives OCs and antibiotics was reported.
It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma levels of oral contraceptives. Another review of the subject concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives.
Cefaclor: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cefadroxil: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefazolin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefdinir: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cefditoren: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefepime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefiderocol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cefixime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cefotaxime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefotetan: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefoxitin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cefpodoxime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefprozil: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ceftaroline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Ceftazidime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ceftazidime; Avibactam: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ceftibuten: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Ceftizoxime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ceftolozane; Tazobactam: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Ceftriaxone: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Cefuroxime: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Cenobamate: Major Women taking both progestins and cenobamate should report breakthrough bleeding to their prescribers. If used for contraception, an alternate or additional form of contraception should be considered in patients prescribed cenobamate.
The alternative or additional contraceptive agent may need to be continued for 1 month after discontinuation of cenobamate. Patients taking these hormones for other indications may need to be monitored for reduced clinical effect while on cenobamate, with dose adjustments made based on clinical efficacy. Concurrent administration may increase progestin elimination. Cephalexin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Charcoal: Major Note that charcoal exerts a nonspecific effect, and many medications can be adsorbed by activated charcoal; repeat doses may decrease the enterohepatic recycling of some drugs. Activated charcoal dietary supplements may have the potential to reduce the effectiveness of oral contraceptives.
Data clearly demonstrating this interaction are not available. Ovulatory potential was studied during the use of two monophasic oral contraceptive pill preparations, after repeated mid-cycle administration of activated charcoal to treat diarrhea in women.
None of eleven women ovulated. Repeated charcoal treatment, when administered 3 hours after but at least 12 hours before pill intake, did not alter oral contraceptive efficacy. Chenodiol: Minor Estrogens and combination hormonal oral contraceptives increase hepatic cholesterol secretion, and encourage cholesterol gallstone formation and hence may theoretically counteract the effectiveness of chenodiol. Chloramphenicol: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Strong CYP3A4 inhibitors include chloramphenicol. Chlorpropamide: Minor Progestins can impair glucose tolerance. Ciprofloxacin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Clarithromycin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Clindamycin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Hormonal contraceptives may not be reliable when coadministered with clobazam. Females taking hormonal-based birth control should use additional non-hormonal methods and not rely solely on hormonal contraceptive methods when taking clobazam. The additional contraceptive agent may need to be continued for 1 month after discontinuation of the interacting medication.
Hormonal contraceptives include combination oral contraceptives, non-oral combination contraceptives, and contraceptives containing only progestins and includes oral, injectable, transdermal, vaginal inserts, and implantable forms of hormonal birth control. Clobazam may also reduce the effectiveness of other estrogens or progestins.
Patients taking these hormones for other indications may need to be monitored for reduced clinical effect while on clobazam, with adjustments made based on clinical efficacy. Cobicistat: Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone. Colistimethate, Colistin, Polymyxin E: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Dabrafenib: Major Avoid concomitant use of dabrafenib and hormonal contraceptives; decreased hormonal contraceptive concentrations and loss of efficacy may occur.
Use of an alternative non-hormonal contraceptive method of birth control is recommended during treatment for 2 weeks after the last dose of dabrafenib. Dalbavancin: Moderate It was previously thought that antibiotics may decrease the effectiveness of oral contraceptives containing estrogens due to stimulation of estrogen metabolism or a reduction in estrogen enterohepatic circulation via changes in GI flora.
Dapagliflozin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Dapagliflozin; Metformin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Dapagliflozin; Saxagliptin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance.
Minor Progestins can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Daptomycin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Darunavir: Major Studies evaluating use of darunavir boosted with either ritonavir or cobicistat with norethindrone have not been conducted; therefore, an alternative non-hormonal method of contraception is recommended. Taking these drugs together may alter the exposure and serum concentrations of norethindrone. If the drugs must be used together, instruct women to report any breakthrough bleeding or other adverse effects e.
It may be prudent for women who receive hormonal contraceptives with darunavir boosted with ritonavir or cobicistat to use an additional method of contraception to protect against unwanted pregnancy.
Darunavir; Cobicistat: Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone. Major Studies evaluating use of darunavir boosted with either ritonavir or cobicistat with norethindrone have not been conducted; therefore, an alternative non-hormonal method of contraception is recommended.
Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone. Data on the effects that protease inhibitors have on the serum concentrations of norethindrone are complex and are based mostly off of data with norethindrone-containing contraceptives. For example, ritonavir also found in combinations like lopinavir; ritonavir, and used as a booster in many HIV treatment regimens may decrease the metabolism of norethindrone, raising norethindrone concentrations.
Women receiving norethindrone for hormone replacement or contraception should report potential hormonal adverse effects e. Deferasirox: Moderate Counsel patients to use non-hormonal methods of contraception during treatment with deferasirox.
Deferasirox may induce the CYP3A4 metabolism of hormonal contraceptives; thereby decreasing their effectiveness. Delafloxacin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Demeclocycline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Dicloxacillin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used with antibiotics. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of estrogen metabolism or a reduction in estrogen enterohepatic circulation via changes in GI flora.
Another review of the subject concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines and penicillin derivatives.
Doripenem: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Doxycycline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Efavirenz: Major Patients should be advised to use a reliable method of barrier contraception in addition to oral contraceptives or non-oral combination contraceptives, including implantable etonogestrel, while using efavirenz.
Efavirenz has no effect on ethinyl estradiol concentrations, but levels of progestins norelgestromin and levonorgestrel can be markedly decreased. There have been post-marketing reports of contraceptive failure with implantable etonogestrel in efavirenz-exposed patients.
Decreased exposure of etonogestrel may be expected. Efavirenz; Emtricitabine; Tenofovir: Major Patients should be advised to use a reliable method of barrier contraception in addition to oral contraceptives or non-oral combination contraceptives, including implantable etonogestrel, while using efavirenz. Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Major Patients should be advised to use a reliable method of barrier contraception in addition to oral contraceptives or non-oral combination contraceptives, including implantable etonogestrel, while using efavirenz.
Elagolix: Major During use of elagolix, females of childbearing potential should use non-hormonal methods of contraception for the duration of treatment and for 28 days following the discontinuation of therapy. Estrogen-containing injectable, implantable, transdermal, vaginal or oral contraceptives are expected to reduce the efficacy of elagolix. The effect of progestin-only contraceptives on elagolix is not known. However, elagolix is a weak to moderate inducer of CYP3A4, and many estrogens and progestins are metabolized via this enzyme.
Thus, elagolix may decrease plasma concentrations of hormonal contraceptives. Coadministration of elagolix mg twice daily and a combined oral contraceptive COC containing 0. Coadministration of elagolix with COCs containing norethindrone acetate did not show reduction in plasma concentrations of norethindrone. Elagolix may also increase contraceptive concentrations. Elagolix; Estradiol; Norethindrone acetate: Major During use of elagolix, females of childbearing potential should use non-hormonal methods of contraception for the duration of treatment and for 28 days following the discontinuation of therapy.
Elvitegravir: Moderate Consider the benefits and risk of administering elvitegravir with ethinyl estradiol; norgestimate and other combination oral contraceptives. Concurrent use may result in elevated norgestimate and reduced ethinyl estradiol serum concentrations. Risk associated with these altered concentrations may include increased insulin resistance, dyslipidemia, acne, and venous thrombosis. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone.
Moderate Consider the benefits and risk of administering elvitegravir with ethinyl estradiol; norgestimate and other combination oral contraceptives.
Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: Major Consider the benefits and risk of administering antiretroviral regimens containing cobicistat with norethindrone. Empagliflozin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance.
Empagliflozin; Linagliptin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Patients receiving antidiabetic agents, such as linagliptin, should be closely monitored for changes in diabetic control when hormone therapy is instituted or discontinued.
Empagliflozin; Linagliptin; Metformin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Empagliflozin; Metformin: Minor Estrogens, progestins, or oral contraceptives can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Encorafenib: Major Avoid coadministration of encorafenib and hormonal contraceptives due to the potential for loss of contraceptive efficacy.
Advise females of reproductive potential to use an effective, non-hormonal method of contraception during treatment and for 2 weeks after the final dose of encorafenib.
Encorafenib can cause fetal harm when administered during pregnancy. Enzalutamide: Major Avoid coadministration of enzalutamide with progestins if used for contraception; consider an alternate or additional form of contraception. The alternative or additional contraceptive agent may need to be continued for 1 month after discontinuation of enzalutamide. Patients taking hormonal replacement therapy may need to be monitored for reduced clinical effect while on enzalutamide, with dose adjustments made based on clinical efficacy.
Women taking hormonal replacement and enzalutamide should report breakthrough bleeding, hot flashes, or other symptoms to their prescribers. Concurrent administration of enzalutamide with progestins, oral contraceptives, or non-oral combination contraceptives may reduce hormonal concentrations.
Eravacycline: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ertapenem: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Ertugliflozin: Minor Progestins can impair glucose tolerance. Ertugliflozin; Metformin: Minor Patients receiving antidiabetic agents like metformin should be closely monitored for signs indicating changes in diabetic control when therapy with progestins is instituted or discontinued.
Ertugliflozin; Sitagliptin: Minor Progestins can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Erythromycin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Erythromycin; Sulfisoxazole: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics. Eslicarbazepine: Major Coadministration of eslicarbazepine with oral contraceptives may result in contraceptive failure.
Coadministration of eslicarbazepine and ethinyl estradiol and levonorgestrel has resulted in decreased plasma concentrations of these hormones. Instruct females of child-bearing potential to use additional or non-hormonal contraception during therapy with eslicarbazepine and after treatment has been discontinued for at least one menstrual cycle.
Etravirine: Major Women taking both progestins and etravirine should report breakthrough bleeding to their prescribers. An alternate or additional form of contraception should be considered in patients prescribed etravirine. The alternative or additional contraceptive agent may need to be continued for one month after discontinuation of etravirine.
Felbamate: Major Based on very limited data, it appears felbamate can accelerate the clearance of the estrogen component of some oral contraceptives. Patients who experience breakthrough bleeding while receiving these drugs together should notify their prescribers.
An alternate or additional form of contraception should be used during concomitant treatment. Additionally, patients taking non-oral combination contraceptives or estrogens or progestins for hormone replacement therapy may also experience reduced clinical efficacy; dosage adjustments may be necessary.
Fidaxomicin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used with antibiotics. It was previously thought that antibiotics may decrease the effectiveness of oral contraceptives containing estrogens due to stimulation of estrogen metabolism or a reduction in estrogen enterohepatic circulation via changes in GI flora. Flibanserin: Moderate The concomitant use of flibanserin and multiple weak CYP3A4 inhibitors, including oral contraceptives, may increase flibanserin concentrations, which may increase the risk of flibanserin-induced adverse reactions.
Therefore, patients should be monitored for hypotension, syncope, somnolence, or other adverse reactions, and the risks of combination therapy with multiple weak CYP3A4 inhibitors and flibanserin should be discussed with the patient.
Flibanserin increased the AUC and Cmax of ethinyl estradiol by 1. Flibanserin decreased the levonorgestrel AUC by 1. During pre-marketing evaluation of flibanserin, patients who reported using oral contraceptives had a greater incidence of CNS effects than flibenserin-treated patients who did not report oral contraceptive use, including dizziness Fosamprenavir: Major Oral contraceptives and non-oral combination contraceptives should not be administered with fosamprenavir.
Fosamprenavir should not be coadministered with oral contraceptives as clinically significant hepatic enzyme transaminase elevations may occur with concomitant use. Additionally, hormonal contraceptives, estrogens, and progestins may decrease the serum concentrations of fosamprenavir's active metabolite, amprenavir, which could lead to loss of virologic response and possible viral resistance.
It is not known if fosamprenavir alters the metabolism of other hormonal contraceptives or other estrogen or progestin products. Gemifloxacin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used with antibiotics. These reductions are considered to be clinically insignificant.
Gentamicin: Moderate It would be prudent to recommend alternative or additional contraception when oral contraceptives OCs are used in conjunction with antibiotics.
Glimepiride: Minor Progestins can impair glucose tolerance. Glimepiride; Rosiglitazone: Minor Progestins can impair glucose tolerance. Glipizide: Minor Progestins can impair glucose tolerance. Glipizide; Metformin: Minor Patients receiving antidiabetic agents like metformin should be closely monitored for signs indicating changes in diabetic control when therapy with progestins is instituted or discontinued.
Common side effects of Aygestin include changes in menstrual flow or weight, stomach upset, trouble sleeping, nausea, bloating, acne, abnormal vaginal bleeding, and swollen or painful breasts. Many of these side effects fade after several weeks of taking Aygestin.
Notify your doctor if side effects worsen. Call your doctor if you experience vision changes, weakness on one side, pain in your chest, jaw, or left arm, swelling or warmth in your groin or calf, severe abdominal pain, sudden, heavy vaginal bleeding, yellowing of the eyes or skin jaundice , a sudden, severe headache, dizziness, or confusion.
Many features of MyEndometriosisTeam will not work unless you enable JavaScript support in your browser. Connect with others who understand. Connect with others living with endometriosis. Some women with depression may notice that it becomes worse while taking Aygestin. Its so good to find some Letrozole sisters! I was dxd with adenomyosis and likely endo fairly recently after decades of search. I started Letrozole with progesterone 1.
I… read more. No I'm no longer taking the Aygestin read more. Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with norethindrone. You will find a full list in the manufacturer's information leaflet supplied with your medicine.
The unwanted effects often improve as your body adjusts to the new medicine, but speak with your physician or pharmacist if any of the following continue or become troublesome. Important : norethindrone can also have some serious side-effects, although these occur only rarely. If you experience any of the following symptoms, stop taking the tablets and contact your physician for advice straightaway:. If you experience any other symptoms which you think may be due to this medicine, speak with your physician or pharmacist.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the Emergency Room of your local hospital.
Take the container with you, even if it is empty. This medicine is for you. Never give it to other people even if their condition appears to be the same as yours. If you buy any medicines 'over the counter', always check with a pharmacist that they are suitable to take with your other medicines.
Do not keep out-of-date or unwanted medicines. Ask your pharmacist about ways to dispose of medicines safely in your local area. Dated August Dated December Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.
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