Drug interactions between EEMT and Miradon
| Results for the following 2 drugs: |
|---|
| EEMT (esterified estrogens/methyltestosterone) |
| Miradon (anisindione) |
Interactions between your selected drugs
methyltestosterone ↔ anisindione
Applies to:EEMT (esterified estrogens/methyltestosterone) and Miradon (anisindione)
MONITOR CLOSELY: Androgens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol. In a clinical study (n=15), the concomitant administration of oxandrolone 10 to 20 mg per day increased the half-life of the more active S(-) enantiomer of warfarin from 26 to 48 hours and the systemic exposure (AUC) from 4.55 to 12.08 ng-hr/mL. R(-) warfarin half-life and AUC also increased. Microscopic hematuria and gingival bleeding were reported, and the warfarin dose had to be reduced by 80% to 85% to maintain the desired INR.
MANAGEMENT: During concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
anisindione ↔ esterified estrogens
Applies to:Miradon (anisindione) and EEMT (esterified estrogens/methyltestosterone)
GENERALLY AVOID: Concomitant therapy with estrogen-containing drugs may diminish the therapeutic effects of oral anticoagulants. Estrogens can increase the plasma levels of certain clotting factors such as fibrinogen, prothrombin, and factors VII and VIII in a dose-dependent manner, resulting in increased risk of thromboembolism, stroke, and/or myocardial infarction. The risk may be further increased by lifestyle choices such as smoking and lack of exercise.
MANAGEMENT: Use of estrogen-containing drugs should be avoided in patients receiving anticoagulant therapy unless benefits are anticipated to outweigh the risks. Close clinical and laboratory monitoring are recommended if the combination is prescribed. Patients should be advised to promptly notify their physician if they experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, sudden loss of vision, and pain, redness or swelling in an extremity.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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