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EEMT HS (esterified estrogens / methyltestosterone) Disease Interactions

There are 27 disease interactions with EEMT HS (esterified estrogens / methyltestosterone):

Major

Androgens (Includes EEMT HS) ↔ Carcinoma (Male)

Severe Potential Hazard, High plausibility

Applies to: Prostate Cancer, Breast Cancer -- Male, Benign Prostatic Hyperplasia

The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.

References

  1. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Major

Androgens (Includes EEMT HS) ↔ Fluid Retention

Severe Potential Hazard, High plausibility

Applies to: Liver Disease, Fluid Retention, Congestive Heart Failure, Renal Dysfunction

Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Major

Androgens (Includes EEMT HS) ↔ Hypercalcemia In Breast Cancer

Severe Potential Hazard, Moderate plausibility

Applies to: Breast Cancer

When treated with androgenic anabolic steroids, patients with metastatic breast cancer may develop hypercalcemia due to osteolysis. Frequent determination of urine and serum calcium levels is recommended during therapy with androgenic agents. If hypercalcemia occurs, therapy should be stopped. The development of hypercalcemia may indicate progression of metastases to the bone.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Major

Androgens (Includes EEMT HS) ↔ Hyperlipoproteinemia

Severe Potential Hazard, Moderate plausibility

Applies to: Ischemic Heart Disease, Hyperlipidemia

Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Major

Androgens (Includes EEMT HS) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of androgenic anabolic steroids may be associated with development of cholestatic hepatitis and jaundice. Other, more serious hepatotoxicities such as peliosis hepatis and hepatocellular neoplasms are rare but may occur with prolonged use or high dosages. These latter toxicities may be fatal and often not recognized until they become life-threatening. Patients with preexisting liver diseases should be monitored more closely during therapy with anabolic steroids if they are used. If liver function declines or toxicity occurs, therapy should be withdrawn and the cause investigated.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Major

Androgens (Includes EEMT HS) ↔ Polycythemia

Severe Potential Hazard, Moderate plausibility

Applies to: Polycythemia

Androgenic anabolic steroids may cause polycythemia when given in high dosages or for prolonged periods. Patients with preexisting polycythemia may experience worsening of their condition. Frequent monitoring of clinical status and hemoglobin and hematocrit levels is recommended if androgen therapy is administered to these patients.

References

  1. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
Major

Androgens (Includes EEMT HS) ↔ Suppression Of Clotting Factors

Severe Potential Hazard, Moderate plausibility

Applies to: Bleeding

Androgenic anabolic steroids may cause suppression of clotting factors II, V, VII, and X, and an increase in prothrombin time. Androgen therapy should be administered cautiously in patients with bleeding disorders.

References

  1. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
Major

Estrogens (Includes EEMT HS) ↔ Abnormal Vaginal Bleeding

Severe Potential Hazard, High plausibility

Applies to: Abnormal Uterine Bleeding

The use of estrogens is contraindicated in patients with undiagnosed, abnormal vaginal bleeding. Prolonged (> 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vaginal bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.

References

  1. Buring JE, Bain CJ, Ehrmann RL "Conjugated estrogen use and risk of endometrial cancer." Am J Epidemiol 124 (1986): 434-41
  2. Spengler RF, Clarke EA, Woolever CA, Newman AM, Osborn RW "Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases." Am J Epidemiol 114 (1981): 497-506
  3. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 28 references
Major

Estrogens (Includes EEMT HS) ↔ Carcinomas (Estrogenic)

Severe Potential Hazard, High plausibility

Applies to: Neoplasia -- Estrogen Dependent

The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.

References

  1. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  3. Palmer JR, Rosenberg L, Clarke EA, Miller DR, Shapiro S "Breast cancer risk after estrogen replacement therapy: results from the Toronto Breast Cancer Study." Am J Epidemiol 134 (1991): 1386-95
View all 57 references
Major

Estrogens (Includes EEMT HS) ↔ Hypercalcemia In Breast Cancer

Severe Potential Hazard, Moderate plausibility

Applies to: Breast Cancer

When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.

References

  1. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  2. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Estrace (estradiol)." Bristol-Myers Squibb, Princeton, NJ.
View all 11 references
Major

Estrogens (Includes EEMT HS) ↔ Hypertension

Severe Potential Hazard, High plausibility

Applies to: Hypertension

The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and also progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.

References

  1. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  2. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
  3. Levine AB, Teppa J, Mcgough B, Cowchock FS "Evaluation of the prethrombotic state in pregnancy and in women using oral contraceptives." Contraception 53 (1996): 255-7
View all 52 references
Major

Estrogens (Includes EEMT HS) ↔ Thromboembolism/Cardiovascular

Severe Potential Hazard, High plausibility

Applies to: Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder, Cerebral Vascular Disorder, Ischemic Heart Disease

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic or thromboembolic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Although the clinical significance of these effects is unknown, epidemiological data suggest it may be dose-dependent. The risk is probably slight with the use of newer, low-dose oral contraceptives in the absence of known risk factors (e.g., smoker, particularly over the age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40). However, a much more significant risk has been reported with higher dosages, such as those used to treat prostate or metastatic breast cancer or those used in older formulations of birth control pills. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of breast or prostatic malignancy.

References

  1. Thorogood M "Risk of stroke in users of oral contraceptives." JAMA 281 (1999): 1255-6
  2. Thorogood M, Mann J, Murphy M, Vessey M "Fatal stroke and use of oral contraceptives: findings from a case- control study." Am J Epidemiol 136 (1992): 35-45
  3. Mishell DR "Contraception." N Engl J Med 320 (1989): 777-85
View all 60 references
Major

Estrogens/Progestogens (Includes EEMT HS) ↔ Hepatic Neoplasms

Severe Potential Hazard, High plausibility

Applies to: Hepatic Tumor

The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.

References

  1. Palmer JR, Rosenberg L, Kaufman DW, Warshauer ME, Stolley P, Shapiro S "Oral contraceptive use and liver cancer." Am J Epidemiol 130 (1989): 878-82
  2. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Tavani A, Negri E, Parazzini F, Franceschi S, La Vecchia C "Female hormone utilisation and risk of hepatocellular carcinoma." Br J Cancer 67 (1993): 635-7
View all 32 references
Moderate

Androgens (Includes EEMT HS) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

The metabolic effects of androgenic anabolic steroids may lower blood glucose. Decreased glucose tolerance and increased insulin resistance have also been reported. Patients with diabetes mellitus should be monitored more closely during therapy with androgenic agents, and their antidiabetic regimen adjusted accordingly.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Moderate

Androgens (Includes EEMT HS) ↔ Hypercalcemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperparathyroidism, Hypercalcemia, Renal Dysfunction

Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.

References

  1. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
Moderate

Estrogens (Includes EEMT HS) ↔ Angioedema

Moderate Potential Hazard, Moderate plausibility

Applies to: Angioedema

The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.

Moderate

Estrogens (Includes EEMT HS) ↔ Gallbladder Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Gallbladder Disease

A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease.

References

  1. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  3. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
View all 18 references
Moderate

Estrogens (Includes EEMT HS) ↔ Hypercalcemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperparathyroidism, Hypercalcemia, Renal Dysfunction

Estrogens influence the metabolism of calcium and phosphorus. Intestinal absorption and retention of calcium are increased, which may occasionally result in hypercalcemia. Therapy with estrogens should be administered cautiously in patients with preexisting hypercalcemia, renal dysfunction, or metabolic bone diseases that are associated with hypercalcemia.

References

  1. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  2. "Product Information. Estrace (estradiol)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Estraderm (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
View all 6 references
Moderate

Estrogens (Includes EEMT HS) ↔ Hyperlipidemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

Although estrogens have generally favorable effects on plasma lipids, including increases in HDL and decreases in total cholesterol and LDL, they have also been associated with significant elevations in triglyceride levels, particularly when high dosages are used. Severe hyperlipidemia is known to sometimes cause pancreatitis. Patients with preexisting hyperlipidemia may require closer monitoring during estrogen therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E "Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women." JAMA 280 (1998): 605-13
  2. "Product Information. Estrace (estradiol)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 24 references
Moderate

Estrogens (Includes EEMT HS) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Estrogens are primarily metabolized by the liver. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Therapy with estrogens should be administered cautiously in patients with liver disease. In addition, clinicians should be aware that estrogen therapy may affect liver function tests. Increased sulfobromophthalein retention has been reported with the use of estrogen-containing oral contraceptives and may be expected with larger doses of estrogens.

References

  1. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  2. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  3. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 22 references
Moderate

Estrogens (Includes EEMT HS) ↔ Melasma

Moderate Potential Hazard, Moderate plausibility

Applies to: Melasma

The use of exogenous estrogens may occasionally cause chloasma, especially in women with a history of chloasma gravidarum. Women with a tendency to chloasma should avoid exposure to the sun or ultraviolet radiation while taking combination oral contraceptives.

Moderate

Estrogens/Progestogens (Includes EEMT HS) ↔ Depression

Moderate Potential Hazard, Moderate plausibility

Applies to: Depression

The use of oral contraceptives has been associated with an increased incidence of depression. It is uncertain whether this effect is related to the estrogenic or the progestogenic component of the contraceptive, although excess progesterone activity is associated with depression. Patients with a history of depression receiving estrogen and/or progestogen therapy should be followed closely. The manufacturer of medroxyprogesterone recommends monitoring patients who have a history of depression and to not re- administer medroxyprogesterone if depression recurs.

References

  1. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  3. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
View all 22 references
Moderate

Estrogens/Progestogens (Includes EEMT HS) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Asthma, Seizures, Fluid Retention, Renal Dysfunction, Migraine

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

References

  1. "Product Information. Estrace (estradiol)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  3. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 25 references
Moderate

Estrogens/Progestogens (Includes EEMT HS) ↔ Glucose Intolerance

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen dose. However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Patients with diabetes mellitus should be monitored more closely during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.

References

  1. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. Stubblefield PG "Choosing the best oral contraceptive." Clin Obstet Gynecol 32 (1989): 316-28
  3. Hannaford PC, Kay CR "Oral contraceptives and diabetes mellitus." BMJ 299 (1989): 1315-6
View all 23 references
Moderate

Estrogens/Progestogens (Includes EEMT HS) ↔ Retinal Thrombosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Retinal Disorder, Visual Defect/Disturbance

Estrogens and progestogens may cause retinal thrombosis. Oral contraceptives should be discontinued if there is unexplained partial or complete loss of vision; onset of proptosis or diplopia; papilledema; or retinal vascular lesions. Therapy with these agents should be administered cautiously in patients who have preexisting ocular problems and appropriate diagnostic and therapeutic measures should be instituted. Contact lens wearers who develop visual changes or changes in lens tolerance should be assessed by an ophthalmologist.

Moderate

Estrogens/Progestogens (Includes EEMT HS) ↔ Thyroid Function Tests

Moderate Potential Hazard, Moderate plausibility

Applies to: Thyroid Disease

When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives.

References

  1. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Estratab (esterified estrogens)" Solvay Pharmaceuticals Inc, Marietta, GA.
View all 24 references
Moderate

Androgens (Includes EEMT HS) ↔ Thyroid Function Tests

Minor Potential Hazard, Moderate plausibility

Applies to: Hyperthyroidism, Hypothyroidism

When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.

References

  1. "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.

EEMT HS (esterified estrogens / methyltestosterone) drug Interactions

There are 242 drug interactions with EEMT HS (esterified estrogens / methyltestosterone)

EEMT HS (esterified estrogens / methyltestosterone) alcohol/food Interactions

There are 4 alcohol/food interactions with EEMT HS (esterified estrogens / methyltestosterone)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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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