Drug Interactions between Acthrel and Estrace Vaginal Cream
This report displays the potential drug interactions for the following 2 drugs:
- Acthrel (corticorelin)
- Estrace Vaginal Cream (estradiol topical)
Interactions between your drugs
corticorelin estradiol topical
Applies to: Acthrel (corticorelin) and Estrace Vaginal Cream (estradiol topical)
MONITOR: Estrogens may enhance the systemic effects of both endogenous and exogenous corticosteroids. The proposed mechanism is an increase in serum cortisol-binding globulin (transcortin) induced by estrogens, resulting in a decreased rate of corticosteroid metabolic clearance. The interaction has been reported with estrogens or estrogen-containing oral contraceptives (OCs) and hydrocortisone, prednisone, and prednisolone. In one pharmacokinetic study, the mean plasma clearance of total prednisolone (40 mg IV) in eight female OC users was less than half that of five healthy female non-OC users and eight healthy males, and the prednisolone half-life and mean residence time were longer. There was also a 2-fold increase in the area under the plasma concentration-time curve for unbound prednisolone compared to controls.
MANAGEMENT: Patients treated concomitantly with an estrogen-containing drug may require lower dosages of corticosteroids or adrenocorticotropic agents. Pharmacologic response to these agents should be monitored more closely whenever an estrogen is added to or withdrawn from therapy in patients stabilized on their existing corticosteroid or adrenocorticotropic regimen, and the dosage(s) adjusted as necessary.
References
- Frey BM, Schaad HJ, Frey FJ (1984) "Pharmacokinetic interaction of contraceptive steroids with prednisone and prednisolone." Eur J Clin Pharmacol, 26, p. 505-11
- Meffin PJ, Wing LM, Sallustio BC, Brooks PM (1984) "Alterations in prednisolone as a result of oral contraceptive use and dose." Br J Clin Pharmacol, 17, p. 655-64
- Legler UF, Benet LZ (1986) "Marked alterations in dose-dependent prednisolone kinetics in women taking oral contraceptives." Clin Pharmacol Ther, 39, p. 425-9
- Olivesi A (1986) "Modified elimination of prednisolone in epileptic patients on carbamazepine monotherapy, and in women using low-dose oral contraceptives." Biomed Pharmacother, 40, p. 301-8
- Boekenoogen SJ, Szefler SJ, Jusko WJ (1983) "Prednisolone disposition and protein binding in oral contraceptive users." J Clin Endocrinol Metab, 56, p. 702-8
- "Product Information. Ortho-Novum 1/35 (ethinyl estradiol-norethindrone)." Ortho McNeil Pharmaceutical
- (2001) "Product Information. Premarin (conjugated estrogens)." Wyeth-Ayerst Laboratories
- (2021) "Product Information. Nextstellis (drospirenone-estetrol)." Mayne Pharma
Drug and food interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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