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Drug Interactions between bazedoxifene / conjugated estrogens and raloxifene

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

conjugated estrogens raloxifene

Applies to: bazedoxifene / conjugated estrogens and raloxifene

GENERALLY AVOID: The concurrent use of raloxifene and systemic estrogen or hormone replacement therapy has not been evaluated in prospective clinical trials. Safety and efficacy of this combination are unknown. However, concomitant use of vaginal estrogen preparations was allowed in clinical trials for treatment of atrophic vaginal symptoms if necessary.

MANAGEMENT: Due to the lack of clinical data, use of raloxifene with systemic estrogens is not recommended.

References (1)
  1. (2001) "Product Information. Evista (raloxifene)." Lilly, Eli and Company

Drug and food interactions

Minor

conjugated estrogens food

Applies to: bazedoxifene / conjugated estrogens

Coadministration with grapefruit juice may increase the bioavailability of oral estrogens. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall induced by certain compounds present in grapefruits. In a small, randomized, crossover study, the administration of ethinyl estradiol with grapefruit juice (compared to herbal tea) increased peak plasma drug concentration (Cmax) by 37% and area under the concentration-time curve (AUC) by 28%. Based on these findings, grapefruit juice is unlikely to affect the overall safety profile of ethinyl estradiol. However, as with other drug interactions involving grapefruit juice, the pharmacokinetic alterations are subject to a high degree of interpatient variability. Also, the effect on other estrogens has not been studied.

References (2)
  1. Weber A, Jager R, Borner A, et al. (1996) "Can grapefruit juice influence ethinyl estradiol bioavailability?" Contraception, 53, p. 41-7
  2. Schubert W, Eriksson U, Edgar B, Cullberg G, Hedner T (1995) "Flavonoids in grapefruit juice inhibit the in vitro hepatic metabolism of 17B-estradiol." Eur J Drug Metab Pharmacokinet, 20, p. 219-24

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Selective estrogen receptor modulators

Therapeutic duplication

The recommended maximum number of medicines in the 'selective estrogen receptor modulators' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'selective estrogen receptor modulators' category:

  • bazedoxifene/conjugated estrogens
  • raloxifene

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Bone resorption inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'bone resorption inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'bone resorption inhibitors' category:

  • bazedoxifene/conjugated estrogens
  • raloxifene

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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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.

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