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Nexplanon Disease Interactions

There are 9 disease interactions with Nexplanon (etonogestrel).

Major

Contraceptives (applies to Nexplanon) abnormal genital bleeding

Major Potential Hazard, Moderate plausibility. Applicable conditions: Abnormal Uterine Bleeding

The use of contraceptives is contraindicated when there is an undiagnosed abnormal genital bleeding. Adequate diagnostic measures should be undertaken to rule out the presence of any malignancy.

References

  1. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  2. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
  3. "Product Information. Liletta (levonorgestrel)." Actavis Pharma, Inc. (2016):
Major

Estrogens/progestogens (applies to Nexplanon) hepatic neoplasms

Major Potential Hazard, Moderate plausibility. Applicable conditions: 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. Tao LC "Oral contraceptive-associated liver cell adenoma and hepatocellular carcinoma." Cancer 68 (1991): 341-7
  2. "Depot-medroxyprogesterone acetate (DMPA) and risk of liver cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives." Int J Cancer 49 (1991): 182-5
  3. Conter RL, Longmire WP Jr "Recurrent hepatic hemangiomas. Possible association with estrogen therapy." Ann Surg 207 (1988): 115-9
  4. Aldinger K, Whalen G, Ben-Menachem Y "Focal nodular hyperplasia of the liver associated with high-dosage estrogens." Arch Intern Med 137 (1977): 357-9
  5. Palmer JR, Kaufman DW, Stolley P, Rosenberg L, Shapiro S, Warshauer ME "Oral contraceptive use and liver cancer." Am J Epidemiol 130 (1989): 878-82
  6. Mooney MJ, Carter PL, Hall RA, Nyreen MR "Hepatic adenoma presenting as a right lower quadrant mass." Am Surg 59 (1993): 229-31
  7. Bredfeldt JE, Black WC, Gyorffy EJ "Transformation of hepatic cell adenoma to hepatocellular carcinoma due to oral contraceptive use." Ann Intern Med 110 (1989): 489-90
  8. Franceschi S, Tavani A, Parazzini F, La Vecchia C, Negri E "Female hormone utilisation and risk of hepatocellular carcinoma." Br J Cancer 67 (1993): 635-7
  9. Anglade MC, Dhumeaux D, Zafrani ES, Mathieu D "Association of focal nodular hyperplasia and hepatic hemangioma." Gastroenterology 97 (1989): 154-7
  10. Le Bail B, Balabaud C, Saric J, Bioulac-Sage P, Deugnier Y, Jouhanole H, Pellegrin JL, Salame G "Liver adenomatosis with granulomas in two patients on long-term oral contraceptives." Am J Surg Pathol 16 (1992): 982-7
  11. "Oral contraceptives and neoplasia. WHO Scientific Group." World Health Organ Tech Rep Ser 817 (1992): 1-46
  12. Mishell DR "Contraception." N Engl J Med 320 (1989): 777-85
  13. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories (2001):
  14. "Product Information. Climara (estradiol)." Berlex Laboratories (2001):
  15. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories (2001):
  16. "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  17. "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  18. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  19. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical (2001):
  20. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  21. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  22. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical (2001):
  23. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories (2001):
  24. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  25. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical (2001):
  26. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  27. "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn (2001):
  28. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  29. "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc (2001):
  30. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  31. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  32. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  33. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
  34. "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma (2021):
View all 34 references
Major

Progestogens (applies to Nexplanon) breast malignancy

Major Potential Hazard, High plausibility. Applicable conditions: Breast Cancer

The use of progestogens is considered by manufacturers to be contraindicated in patients with existing or suspected malignancy of the breast. Some supportive data are available for medroxyprogesterone. Specifically, medroxyprogesterone treatment may be associated with breast cancer, primarily when the drug is administered intramuscularly. A pooled analysis of two case-control studies, one from the World Health Organization and the other from New Zealand, revealed a small overall relative risk of breast cancer in women who have ever used intramuscular medroxyprogesterone acetate. The relative risk was higher in the subgroup of women who had initiated therapy within the previous 5 years. Thus, an increased risk (approximately 2-fold) is associated with intramuscular medroxyprogesterone use in the first 5 years. A more recent U.S. study also found a statistically significant increase in breast cancer risk among recent users (defined as last use within the past five years) who used depo-medroxyprogesterone acetate for 12 months or longer.

References

  1. Michelson MJ, Layde PM, Potts M, Hatcher RA, Levenson AG, Liang AP, Shelton JD "Risk of breast, uterine corpus, and ovarian cancer in women receiving medroxyprogesterone injections." JAMA 249 (1983): 2909-12
  2. "Breast cancer, cervical cancer, and depot medroxyprogesterone acetate. WHO Collaborative Study of Neoplasia and Steroid Contraceptives" Lancet 2 (1984): 1207-8
  3. "Breast cancer and depot-medroxyprogesterone acetate: a multinational study. WHO Collaborative Study of Neoplasia and Steroid Contraceptives" Lancet 338 (1991): 833-8
  4. Jordan A "Toxicology of depot medroxyprogesterone acetate." Contraception 49 (1994): 189-201
  5. Chilvers C "Breast cancer and depot-medroxyprogesterone acetate - a review." Contraception 49 (1994): 211-22
  6. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  7. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  8. Meirik O, Paul C, Thomas DB, Noonan EA, Skegg DC, Spears GF "Depot medroxyprogesterone acetate and breast cancer." JAMA 273 (1995): 799-807
  9. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  10. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  11. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  12. "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC (2001):
  13. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
View all 13 references
Major

Progestogens (applies to Nexplanon) liver disease

Major Potential Hazard, Moderate plausibility.

The use of progestogens, in general, is contraindicated in patients with impaired hepatic function or liver disease. There are little or no data concerning the pharmacokinetic disposition of the different progestogens in patients with hepatic disease. However, most hormones, including progestational hormones, are known to be extensively metabolized by the liver. Medroxyprogesterone should not be used by women with significant liver disease and should be discontinued if jaundice or disturbances of liver function occur.

References

  1. Aakvaag A, Kvinnsland S, Lundgren S, Utaaker E "Pharmacokinetics and metabolism of medroxyprogesterone acetate in patients with advanced breast cancer." J Steroid Biochem 31 (1988): 437-41
  2. Sala G, Castegnaro E "Pharmacokinetics and metabolism of medroxyprogesterone acetate. Influence of the route of administration and of its physical state." Steroidologia 2 (1971): 13-26
  3. Kauppila A, Riippa P, Sundstrom H, Vihko R "Hepatic impairment during simultaneous administration of medroxyprogesterone acetate and tamoxifen in the treatment of endometrial and ovarian carcinoma." Anticancer Res 4 (1984): 109-12
  4. 3d Wiener I, Emory LE, Meyer WJ, Cole CM, Fagan CJ, Isenberg N, Thompson JC "Cholelithiasis associated with medroxyprogesterone acetate therapy in men." Res Commun Chem Pathol Pharmacol 75 (1992): 69-84
  5. Galand N, Hendeles SM, Schwers J "Metabolism of orally administered D-norgestrel in women." Acta Endocrinol (Copenh) 71 (1972): 557-68
  6. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  7. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  8. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  9. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  10. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  11. "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC (2001):
  12. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
View all 12 references
Major

Progestogens (applies to Nexplanon) thromboembolism

Major Potential Hazard, Moderate plausibility. Applicable conditions: Cerebral Vascular Disorder, Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder

The use of progestogens, in general, is considered by manufacturers to be contraindicated in patients with active thrombophlebitis, cerebrovascular disease, or a current or past history of thromboembolic disorders. While the role of progestogens in the development of thromboembolic events associated with hormonal therapy is often unclear and thought to be secondary to that of estrogens, it may not be insignificant. Medroxyprogesterone, a common progestational agent, has been shown to produce a hypercoagulable state in high dosages. Whether or not this effect contributes to the development of thrombotic events is unknown. However, thrombophlebitis and pulmonary embolism have been reported with megestrol, an antineoplastic and progestational agent. In addition, an increased risk of nonfatal venous thrombosis has been associated with oral contraceptive combinations containing desogestrel or gestodene relative to those that contain other progestins (e.g., levonorgestrel, norethindrone), suggesting some degree of hemostatic effect by progestogens.

References

  1. Astedt B, Jeppsson S, Pandolfi M "Fibrinolytic activity of veins during use of depot medroxyprogesterone acetate as a contraceptive." Fertil Steril 23 (1972): 489-92
  2. Imaoka S, Noguchi S, Iwanaga T, Miyauchi K, Inaji H, Koyama H, Yamamoto H "Changes in hematologic parameters during treatment with medroxyprogesterone acetate for breast cancer." Jpn J Cancer Res 82 (1991): 420-5
  3. Adachi I, Fukutomi T, Yamamoto H, Nanasawa T, Watanabe T "The induction of a hypercoagulable state by medroxyprogesterone acetate in breast cancer patients." Jpn J Surg 20 (1990): 665-70
  4. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  5. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  6. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  7. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical (2001):
  8. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  9. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  10. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical (2001):
  11. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories (2001):
  12. "Product Information. Megace (megestrol)." Bristol-Myers Squibb (2001):
  13. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  14. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  15. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  16. "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC (2001):
  17. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
View all 17 references
Moderate

Estrogens/progestogens (applies to Nexplanon) depression

Moderate Potential Hazard, Moderate plausibility.

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. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  2. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  3. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories (2001):
  4. "Product Information. Climara (estradiol)." Berlex Laboratories (2001):
  5. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories (2001):
  6. "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  7. "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  8. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  9. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical (2001):
  10. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  11. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  12. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical (2001):
  13. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories (2001):
  14. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  15. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical (2001):
  16. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  17. "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn (2001):
  18. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  19. "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc (2001):
  20. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  21. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  22. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  23. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
  24. "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma (2021):
View all 24 references
Moderate

Estrogens/progestogens (applies to Nexplanon) fluid retention

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure, Migraine, Asthma, Seizures, Renal Dysfunction, Hypertension

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. Leiman G "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol 114 (1972): 97-102
  2. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  3. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn (2001):
  4. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories (2001):
  5. "Product Information. Climara (estradiol)." Berlex Laboratories (2001):
  6. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories (2001):
  7. "Product Information. Estraderm (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  8. "Product Information. Vivelle (estradiol)." Ciba-Geigy Pharmaceuticals (2001):
  9. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  10. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical (2001):
  11. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  12. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  13. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical (2001):
  14. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories (2001):
  15. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  16. "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn (2001):
  17. "Product Information. Megace (megestrol)." Bristol-Myers Squibb (2001):
  18. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical (2001):
  19. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  20. "Product Information. Ogen (estropipate topical)." Pharmacia and Upjohn (2001):
  21. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  22. "Product Information. Estratab (esterified estrogens)." Solvay Pharmaceuticals Inc (2001):
  23. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  24. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  25. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  26. "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC (2001):
  27. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):
View all 27 references
Moderate

Estrogens/progestogens (applies to Nexplanon) retinal thrombosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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.

References

  1. "Product Information. Ortho-Novum (oral contraceptive combination pill)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  3. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho McNeil Pharmaceutical (2001):
  4. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  5. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  6. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho McNeil Pharmaceutical (2001):
  7. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories (2001):
  8. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  9. "Product Information. Norplant System (levonorgestrel)." Wyeth-Ayerst Laboratories (2001):
  10. "Product Information. Micronor (norethindrone)." Ortho McNeil Pharmaceutical (2001):
  11. "Product Information. Ovrette (norgestrel)." Wyeth-Ayerst Laboratories (2001):
  12. "Product Information. Prometrium (progesterone)." Virtus Pharmaceuticals LLC (2001):
  13. "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma (2021):
View all 13 references
Moderate

Etonogestrel (applies to Nexplanon) gallbladder disease

Moderate Potential Hazard, Moderate plausibility.

Etonogestrel might increase the risk of gallbladder disease. Caution and monitoring of symptoms is suggested in patients with history or active gallbladder disease.

References

  1. "Product Information. Implanon (etonogestrel)." Organon Pharmaceuticals (2006):

Nexplanon drug interactions

There are 216 drug interactions with Nexplanon (etonogestrel).

Nexplanon alcohol/food interactions

There are 2 alcohol/food interactions with Nexplanon (etonogestrel).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.