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Drug Interactions between conjugated estrogens / medroxyprogesterone and lesinurad

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

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Interactions between your drugs

Moderate

medroxyPROGESTERone lesinurad

Applies to: conjugated estrogens / medroxyprogesterone and lesinurad

ADDITIONAL CONTRACEPTION RECOMMENDED: Coadministration with lesinurad may decrease the plasma concentrations of contraceptive hormones and reduce their effectiveness. The interaction has not been evaluated in pharmacokinetic studies. However, lesinurad is a weak inducer of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of contraceptive hormones. Lesinurad has been shown to induce the metabolism of other CYP450 3A4 substrates in interaction studies.

MANAGEMENT: Hormonal contraceptives, including oral, injectable, transdermal, and implantable forms, may not be reliable when used with lesinurad. Female patients of reproductive potential receiving hormonal contraceptives should practice additional methods of contraception during treatment with lesinurad.

References (1)
  1. (2015) "Product Information. Zurampic (lesinurad)." Astra-Zeneca Pharmaceuticals

Drug and food interactions

Minor

conjugated estrogens food

Applies to: conjugated estrogens / medroxyprogesterone

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

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.

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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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