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Next Choice (levonorgestrel) Disease Interactions

There are 13 disease interactions with Next Choice (levonorgestrel):

Major

Contraceptives (Includes Next Choice) ↔ 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 Next Choice) ↔ 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. 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
  3. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  4. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  5. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  6. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  8. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. Le Bail B, Jouhanole H, Deugnier Y, Salame G, Pellegrin JL, Saric J, Balabaud C, Bioulac-Sage P "Liver adenomatosis with granulomas in two patients on long-term oral contraceptives." Am J Surg Pathol 16 (1992): 982-7
  10. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  11. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  12. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. Gyorffy EJ, Bredfeldt JE, Black WC "Transformation of hepatic cell adenoma to hepatocellular carcinoma due to oral contraceptive use." Ann Intern Med 110 (1989): 489-90
  14. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  15. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  16. "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
  17. "Oral contraceptives and neoplasia. WHO Scientific Group." World Health Organ Tech Rep Ser 817 (1992): 1-46
  18. "Product Information. Vivelle (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  19. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories, Rockaway, NJ.
  20. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
  21. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  22. "Product Information. Estraderm (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  23. Mathieu D, Zafrani ES, Anglade MC, Dhumeaux D "Association of focal nodular hyperplasia and hepatic hemangioma." Gastroenterology 97 (1989): 154-7
  24. "Product Information. Estratab (esterified estrogens)" Solvay Pharmaceuticals Inc, Marietta, GA.
  25. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  26. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  27. Mooney MJ, Nyreen MR, Hall RA, Carter PL "Hepatic adenoma presenting as a right lower quadrant mass." Am Surg 59 (1993): 229-31
  28. Mishell DR "Contraception." N Engl J Med 320 (1989): 777-85
  29. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  30. Aldinger K, Ben-Menachem Y, Whalen G "Focal nodular hyperplasia of the liver associated with high-dosage estrogens." Arch Intern Med 137 (1977): 357-9
  31. Conter RL, Longmire WP Jr "Recurrent hepatic hemangiomas. Possible association with estrogen therapy." Ann Surg 207 (1988): 115-9
  32. Tao LC "Oral contraceptive-associated liver cell adenoma and hepatocellular carcinoma." Cancer 68 (1991): 341-7
View all 32 references
Major

Levonorgestrel (Includes Next Choice) ↔ Intracranial Htn

Severe Potential Hazard, High plausibility

Applies to: Intracranial Hypertension

The use of levonorgestrel contraceptive implants is contraindicated in patients with a current or past history of idiopathic intracranial hypertension (pseudotumor cerebri, benign intracranial hypertension). This disorder is most commonly seen in obese women of reproductive age and has been reported in users of levonorgestrel implants. Patients who experience symptoms of this disorder (e.g., headaches associated with changing frequency, pattern, severity or persistence; visual disturbances) while on levonorgestrel therapy should be referred to a neurologist. If the diagnosis is confirmed, the implants should be removed permanently.

References

  1. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
Major

Levonorgestrel (Includes Next Choice) ↔ Thromboembolism

Severe Potential Hazard, Moderate plausibility

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

The use of levonorgestrel is considered by manufacturers to be contraindicated in patients with active thrombophlebitis or thromboembolic disorders. Some manufacturers also recommend not using progestogens in patients with a history of thromboembolic or cerebrovascular disease. 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. Levonorgestrel implants, specifically, have been associated with thrombophlebitis and superficial phlebitis, which were more common in the arm of insertion and sometimes related to trauma to the arm. There have also been post-marketing reports of stroke and myocardial infarction coincident with the use of levonorgestrel implants.

References

  1. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 4 references
Major

Progestogens (Includes Next Choice) ↔ 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. "Breast cancer, cervical cancer, and depot medroxyprogesterone acetate. WHO Collaborative Study of Neoplasia and Steroid Contraceptives" Lancet 2 (1984): 1207-8
  4. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  5. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Skegg DC, Noonan EA, Paul C, Spears GF, Meirik O, Thomas DB "Depot medroxyprogesterone acetate and breast cancer." JAMA 273 (1995): 799-807
  7. "Breast cancer and depot-medroxyprogesterone acetate: a multinational study. WHO Collaborative Study of Neoplasia and Steroid Contraceptives" Lancet 338 (1991): 833-8
  8. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  10. Liang AP, Levenson AG, Layde PM, Shelton JD, Hatcher RA, Potts M, Michelson MJ "Risk of breast, uterine corpus, and ovarian cancer in women receiving medroxyprogesterone injections." JAMA 249 (1983): 2909-12
  11. Chilvers C "Breast cancer and depot-medroxyprogesterone acetate - a review." Contraception 49 (1994): 211-22
View all 11 references
Major

Progestogens (Includes Next Choice) ↔ Liver Disease

Severe Potential Hazard, High 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. Riippa P, Kauppila A, 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. Utaaker E, Lundgren S, Kvinnsland S, Aakvaag A "Pharmacokinetics and metabolism of medroxyprogesterone acetate in patients with advanced breast cancer." J Steroid Biochem 31 (1988): 437-41
  5. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. Hendeles SM, Galand N, Schwers J "Metabolism of orally administered D-norgestrel in women." Acta Endocrinol (Copenh) 71 (1972): 557-68
  9. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  10. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 10 references
Moderate

Estrogens/Progestogens (Includes Next Choice) ↔ 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. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  2. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  4. "Product Information. Estratab (esterified estrogens)" Solvay Pharmaceuticals Inc, Marietta, GA.
  5. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories, Rockaway, NJ.
  6. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
  7. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  8. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  9. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  10. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  11. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  12. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Estraderm (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  14. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  15. "Product Information. Vivelle (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  16. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  17. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  18. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  19. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  20. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  21. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  22. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 22 references
Moderate

Estrogens/Progestogens (Includes Next Choice) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Fluid Retention, Migraine, Asthma, Seizures, Congestive Heart Failure, 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)." Warner Chilcott Laboratories, Rockaway, NJ.
  2. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  3. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  5. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  7. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  9. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  10. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  11. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  14. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
  15. "Product Information. Vivelle (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  16. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  17. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Megace (megestrol)." Bristol-Myers Squibb, Princeton, NJ.
  19. Leiman G "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol 114 (1972): 97-102
  20. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  21. "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn, Kalamazoo, MI.
  22. "Product Information. Ortho-Est (estropipate)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  23. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  24. "Product Information. Estratab (esterified estrogens)" Solvay Pharmaceuticals Inc, Marietta, GA.
  25. "Product Information. Estraderm (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
View all 25 references
Moderate

Estrogens/Progestogens (Includes Next Choice) ↔ 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. Hannaford PC, Kay CR "Oral contraceptives and diabetes mellitus." BMJ 299 (1989): 1315-6
  3. Belchetz PE "Hormonal treatment of postmenopausal women." N Engl J Med 330 (1994): 1062-71
  4. Stubblefield PG "Choosing the best oral contraceptive." Clin Obstet Gynecol 32 (1989): 316-28
  5. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Luciano AA, De Souza MJ, Roy MP, Schoenfeld MJ, Nulsen JC, Halvorson CV "Evaluation of low-dose estrogen and progestin therapy in postmenopausal women." J Reprod Med 38 (1993): 207-14
  7. Derman R "Oral contraceptives: a reassessment." Obstet Gynecol Surv 44 (1989): 662-8
  8. Spellacy WN, Ellingson AB, Tsibris JC "The effects of two triphasic oral contraceptives on carbohydrate metabolism in women during 1 year of use." Fertil Steril 51 (1989): 71-4
  9. Virutamasen P, Wongsrichanalai C, Tangkeo P, Nitichai Y, Rienprayoon D "Metabolic effects of depot-medroxyprogesterone acetate in long-term users: a cross-sectional study." Int J Gynaecol Obstet 24 (1986): 291-6
  10. Kaunitz AM "Long-acting injectable contraception with depot medroxyprogesterone acetate." Am J Obstet Gynecol 170 (1994): 1543-9
  11. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  12. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  13. Garg SK, Chase HP, Marshall G, Hoops SL, Holmes DL, Jackson WE "Oral contraceptives and renal and retinal complications in young women with insulin-dependent diabetes mellitus." JAMA 271 (1994): 1099-102
  14. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  15. Steinberg WM "Oral contraception: risks and benefits." Adv Contracept 5 (1989): 219-28
  16. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  17. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  18. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  19. Haiba NA, el-Habashy MA, Said SA, Darwish EA, Abdel-Sayed WS, Nayel SE "Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters." Contraception 39 (1989): 619-32
  20. "Product Information. Ortho-Novum (oral contraceptive combination pill)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  21. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  22. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. Who Task Force on Long-acting Agents for Fertility Regulation "Metabolic side-effects of injectable depot-medroxyprogesterone acetate, 150 mg three-monthly, in undernourished lactating women." Bull World Health Organ 64 (1986): 587-94
View all 23 references
Moderate

Estrogens/Progestogens (Includes Next Choice) ↔ Retinal Thrombosis

Moderate Potential Hazard, Moderate plausibility

Applies to: 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 Next Choice) ↔ 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.
  4. "Product Information. Estraderm (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  5. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  6. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  7. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  9. "Product Information. Estinyl Tablets (ethinyl estradiol)" Schering Corporation, Kenilworth, NJ.
  10. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  11. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  13. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  14. "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  15. "Product Information. Estrace (estradiol)." Warner Chilcott Laboratories, Rockaway, NJ.
  16. "Product Information. Ortho Dienestrol Cream (dienestrol topical)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  17. "Product Information. Vivelle (estradiol)." Ciba Pharmaceuticals, Summit, NJ.
  18. "Product Information. Climara (estradiol)." Berlex, Richmond, CA.
  19. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  20. "Product Information. Emcyt (estramustine)." Pharmacia and Upjohn, Kalamazoo, MI.
  21. "Product Information. Ortho Novum 1/50 (mestranol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  22. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  24. "Product Information. Ogen (estropipate topical)" Pharmacia and Upjohn, Kalamazoo, MI.
View all 24 references
Moderate

Progestogens (Includes Next Choice) ↔ Hyperlipidemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

Some progestogenic agents may elevate plasma LDL levels and/or lower HDL levels, although data have been inconsistent. Patients with preexisting hyperlipidemia may require closer monitoring during progestogen therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. Luciano AA, De Souza MJ, Roy MP, Schoenfeld MJ, Nulsen JC, Halvorson CV "Evaluation of low-dose estrogen and progestin therapy in postmenopausal women." J Reprod Med 38 (1993): 207-14
  4. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  5. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  6. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. Barnes RB, Roy S, Lobo RA "Comparison of lipid and androgen levels after conjugated estrogen or depo-medroxyprogesterone acetate treatment in postmenopausal women." Obstet Gynecol 66 (1985): 216-9
  8. Haiba NA, el-Habashy MA, Said SA, Darwish EA, Abdel-Sayed WS, Nayel SE "Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters." Contraception 39 (1989): 619-32
  9. Teichmann AT, Wander HE, Cremer P, et al. "Medroxyprogesterone acetate and lipid metabolic changes." Arzneimittelforschung 37 (1987): 573-77
  10. Virutamasen P, Wongsrichanalai C, Tangkeo P, Nitichai Y, Rienprayoon D "Metabolic effects of depot-medroxyprogesterone acetate in long-term users: a cross-sectional study." Int J Gynaecol Obstet 24 (1986): 291-6
  11. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  14. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  15. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  16. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  17. Who Task Force on Long-acting Agents for Fertility Regulation "Metabolic side-effects of injectable depot-medroxyprogesterone acetate, 150 mg three-monthly, in undernourished lactating women." Bull World Health Organ 64 (1986): 587-94
View all 17 references
Moderate

Progestogens (Includes Next Choice) ↔ Weight Gain

Minor Potential Hazard, Moderate plausibility

Applies to: Obesity

Progestogens can cause weight gain, which may be significant (as is the case with parenteral medroxyprogesterone) and undesirable in obese patients attempting to lose weight.

References

  1. "Product Information. Micronor (norethindrone)" Ortho McNeil Pharmaceutical, Raritan, NJ.
  2. "Product Information. Lo/Ovral (ethinyl estradiol-norgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Demulen (ethinyl estradiol-ethynodiol)." Searle, Skokie, IL.
  4. "Product Information. Ortho Novum 10/11 (ethinyl estradiol-norethindrone)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  5. "Product Information. Triphasil (ethinyl estradiol-levonorgestrel)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Depo-Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  7. "Product Information. Ovrette (norgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. Amatayakul K, Sivasomboon B, Thanangkul O "A study of the mechanism of weight gain in medroxyprogesterone acetate users." Contraception 22 (1980): 605-22
  9. "Product Information. Provera (medroxyprogesterone)." Pharmacia and Upjohn, Kalamazoo, MI.
  10. Leiman G "Depo-medroxyprogesterone acetate as a contraceptive agent: its effect on weight and blood pressure." Am J Obstet Gynecol 114 (1972): 97-102
  11. "Product Information. Norplant System (levonorgestrel)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Ortho-Cept (desogestrel-ethinyl estradiol)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  13. "Product Information. Ortho-Cyclen (ethinyl estradiol-norgestimate)." Ortho Pharmaceutical Corporation, Raritan, NJ.
View all 13 references

Next Choice (levonorgestrel) drug Interactions

There are 266 drug interactions with Next Choice (levonorgestrel)

Next Choice (levonorgestrel) alcohol/food Interactions

There are 4 alcohol/food interactions with Next Choice (levonorgestrel)

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.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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