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Etonogestrel Disease Interactions

There are 9 disease interactions with etonogestrel:

Major

Contraceptives (Includes Etonogestrel) ↔ Abnormal Genital Bleeding

Severe Potential Hazard, Moderate plausibility

Applies to: 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.

Major

Estrogens/Progestogens (Includes Etonogestrel) ↔ Hepatic Neoplasms

Severe Potential Hazard, Moderate 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
Major

Progestogens (Includes Etonogestrel) ↔ Breast Malignancy

Severe Potential Hazard, High plausibility

Applies to: 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. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  2. Jordan A "Toxicology of depot medroxyprogesterone acetate." Contraception 49 (1994): 189-201
  3. Skegg DC, Noonan EA, Paul C, Spears GF, Meirik O, Thomas DB "Depot medroxyprogesterone acetate and breast cancer." JAMA 273 (1995): 799-807
View all 11 references
Major

Progestogens (Includes Etonogestrel) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

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. Meyer WJ, 3d Wiener I, Emory LE, Cole CM, Isenberg N, Fagan CJ, Thompson JC "Cholelithiasis associated with medroxyprogesterone acetate therapy in men." Res Commun Chem Pathol Pharmacol 75 (1992): 69-84
  2. Castegnaro E, Sala G "Pharmacokinetics and metabolism of medroxyprogesterone acetate. Influence of the route of administration and of its physical state." Steroidologia 2 (1971): 13-26
  3. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 10 references
Major

Progestogens (Includes Etonogestrel) ↔ Thromboembolism

Severe Potential Hazard, Moderate plausibility

Applies to: 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. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Yamamoto H, Noguchi S, Miyauchi K, Inaji H, Imaoka S, Koyama H, Iwanaga T "Changes in hematologic parameters during treatment with medroxyprogesterone acetate for breast cancer." Jpn J Cancer Res 82 (1991): 420-5
  3. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 15 references
Moderate

Estrogens/Progestogens (Includes Etonogestrel) ↔ 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 Etonogestrel) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Migraine, Asthma, Seizures, Renal Dysfunction, Fluid Retention, 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. "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 Etonogestrel) ↔ 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

Etonogestrel (Includes Etonogestrel) ↔ Gallbladder Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Gallbladder Disease

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

etonogestrel drug Interactions

There are 223 drug interactions with etonogestrel

etonogestrel alcohol/food Interactions

There is 1 alcohol/food interaction with etonogestrel

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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